Hip Flexion Range Of Motion Research Articles

Effects of Preconditioning Lower-Extremity Resistance Exercises on Multidirectional Repeated Sprinting-Induced Muscle Damage.

Hsu, SM, Tseng, WC, Chiu, CH, Hsieh, TY, Weng, MC, Dai, X, and Chen, CH. Effects of preconditioning lower-extremity resistance exercises on multi directional repeated sprinting-induced muscle damage. J Strength Cond Res XX(X): 000-000, 2024-Sprint exercise-induced muscle damage is a popular area of investigation. To examine whether preconditioning lower-extremity resistance exercises would reduce the amount of muscle damage observed after a multi-directional repeated sprinting (MDS) exercise. Thirty-six elite male athletes were randomly allocated to 1 of 3 groups: general warm-up (GW), GW with loaded jump squat (SQ), and GW with loaded hip thrust (HT). Knee flexion isometric strength (MVIC), passive hip flexion range of motion (ROM), soreness, countermovement jump (CMJ), sprint time, and plasma creatine kinase (CK) activity were measured at the pretest and post-24, -48, and -72 hours of the MDS. For SQ, the CK at post-72 hours was significantly lower than the GW group. The decrements of MVIC at post-48 and -72 hours for SQ were significantly less than the GW group. The CMJs at post-24 and -48 hours for SQ and at post-48 and -72 hours for HT were significantly higher than the GW group. The 0-10 m sprint time at post-48 hour for HT was significantly better than the GW group. Adding the SQ or HT interventions to a GW before MDS has a protective effect on the sprinting-induced muscle damage and faster recovery.

The Effects of Static Stretching 2-Hours Prior to a Traditional Warm-Up on Performance.

Whereas prolonged static stretching (SS: >60-seconds per muscle) can increase range of motion (ROM) for up to 2-hours, it can also decrease maximal voluntary isometric contraction (MVIC) forces, countermovement (CMJ) and drop jump (DJ) heights, and muscle activation immediately after the stretching exercise. When an appropriate SS duration (<60-seconds per muscle) is incorporated into a dynamic warm-up, performance decrements are often trivial. However, there is a lack of studies that observed the effects of extensive SS (180-seconds) 2-hours prior to a dynamic warm-up. The objective was to investigate ROM and performance effects of prolonged SS, 2-hours prior to a traditional warm-up. This study investigated 9 female and 8 male healthy recreationally active, young adult participants on the effects of prolonged SS (180-seconds per muscle) of the quadriceps and hamstrings, 2-hours before a traditional warm-up compared to an active control condition on hip flexion ROM, knee extension and flexion MVIC forces, CMJ, DJ, and quadriceps and hamstrings electromyography (EMG). There were no significant changes in knee flexion/extension MVIC forces, EMG, CMJ, or DJ height. However, there was significant, small magnitude (p = 0.002) greater post-warm-up left hip flexion ROM (115.4° ± 17.2) than pre-SS (108.9° ± 17.13, Effect size [ES]: 0.28) and control post-warm-up (p = 0.05, ES: 0.31, 109.5° ± 20.55). Similarly, right hip flexion ROM (117.2° ± 16.5) also demonstrated significant small magnitude (p = 0.003) greater than the pre-SS (112.4° ± 18.4, ES: 0.22) and control post-warm-up (p = 0.046, ES: 0.33, 110.8° ± 20.5). Additionally, significant, large magnitude greater hip flexion ROM was observed with the women vs. men (ES: 1.29 - 1.34). Significant hip flexion ROM increases were not accompanied by significant changes in knee flexion/extension MVIC forces, EMG, or jump heights, suggesting that extensive SS can positively impact ROM without performance deficits when followed by a traditional warm-up, 2-hours after SS.

Platform Design for Optical Screening and Conditioning for Injury Resilience.

Musculoskeletal injuries (MSKIs) among active duty soldiers result in more than 10 million limited duty days each year and account for more than 70% of the medically nondeployable population. Overuse injuries in lower limbs from running, foot marching long distances with heavy loads, and lifting heavy objects are the most common types of injuries in the military. Physical training and rehabilitation exercises for greater resiliency through aerobic, muscle strength, endurance, and agility conditioning programs can prevent or reduce the effects of MSKIs if Soldiers adhere to proper biomechanics and training techniques. We are introducing a three-dimensional (3D) camera-based platform for Optical Screening and Conditioning for Injury Resilience (OSCIR) that is designed to identify and correct high-risk movement patterns based on quantifiable biomechanical measurements in clinical or field settings. Our goal is to improve resilience to MSKI by offering greater access to quality of movement skills in warfighters through an autonomous device that can be used in Sports Medicine and Reconditioning Team (SMART) clinics and High-Intensity Tactical Training (HITT) sites. OSCIR fuses four pairs of Kinect Azure cameras into a concise footprint to achieve suitable sampling rates and an unobstructed field of view for accurate dynamic movement tracking using a custom point cloud solution. We designed a unique multistage 3D joint tracking algorithm architecture to methodically isolate the human body point cloud from the background, identify individual limb segments, and perform iterative joint optimization at the global and local joint levels. We evaluated the feasibility of our prototype system among N = 12 control participants (6 M/6 F; 21-37 years) in compliance with the Western Institutional Review Board (Tracking #20225920, approved on November 4, 2022). Five task-specific MSKI outcome metrics identified by end-user physical therapists and athletic trainers as indicators for movement quality were assessed across 7 lower-extremity exercises derived from standardized MSK assessment/conditioning batteries used in the military. Data were recorded concurrently by OSCIR and a reference standard Vicon motion capture system for validating system accuracy. Task-specific MSKI indicators for knee flexion and hip flexion range of motion achieved an average error of 4.05 ± 2.34°, while 3D position-based postural outcomes of left-right foot distance, left-right hand distance, and step length obtained mean absolute errors of 2.58 ± 2.30 cm. Results support the feasibility of our system in achieving outcomes that are comparable to currently accepted laboratory standards. Our study describes the integration process for a 3D camera-based clinical system for MSKI conditioning and rehabilitation. The impact of our system will enable key stakeholders in the military to manage MSKIs in warfighters by automating key assessment and rehabilitation test batteries; making tests more readily accessible, and interpretations more accurate by providing objective biomechanical measures. OSCIR is undergoing turn-key design features to serve as a screening tool for warfighters to readily assess susceptibility to MSKI or as a training platform to help guide exercise techniques to achieve resiliency against future injuries.

Sustainable effectiveness of kinetic chain stretching on active hip flexion movement and muscle activation for hamstring tightness: A preliminary investigation.

Conventional hamstring (HAM) stretching therapeutic effects are not substantiable in neuromusculoskeletal conditions with HAM tightness or shortness. We developed a kinetic chain stabilization exercise to provide a more sustainable effectiveness in adults with HAM tightness. However, its therapeutic effects and underlying motor mechanisms remain unknown. To compare the effects of traditional active HAM stretching (AHS) and kinetic chain stretching (KCS) on electromyographic (EMG) amplitude and hip flexion range of motion (ROM) in participants with HAM tightness. In this randomized controlled trial, 18 participants (mean age: 25.01 ± 2.47 years) with HAM tightness were assigned to the AHS or KCS group. Hip joint movement, EMG amplitude, and onset times were recorded in the bilateral erector spinae, HAM, transverse abdominis/internal oblique (IO), external oblique (EO), and rectus abdominis during a straight leg raise test. Compared to AHS, KCS led to greater increase in the hip flexion ROM and EMG activation amplitudes in the left and right EO and left IO. Post-test hip flexion ROM data in both the groups were higher than the pre-test data. KCS produced more sustainable effectiveness in hip flexion movement and EMG motor control patterns in participants with HAM tightness than AHS.

Hip and Trunk Variables in University Students with and without Recurrent Low Back Pain.

Low back pain (LBP) is a leading cause of disability. Recurrent low back pain (rLBP) is defined as two or more episodes of LBP in a 12-month period, each lasting more than 24 hours and separated by at least one pain-free month. Many studies have shown that hip and trunk variables have an influence on LBP. However, most of these are studies of participants with acute or chronic LBP rather than rLBP. To examine the difference between hip and trunk variables of university students with and without rLBP. Cross-Sectional. Participants with and without rLBP between 18 and 35 years of age not currently undergoing clinical orthopedic care were recruited for this cross-sectional study. Bilateral hip range of motion (ROM) and trunk ROM were measured with a goniometer or measuring tape (hip motions in all planes along with trunk flexion, extension, and lateral flexion). Strength of the hip extensors, abductors, and external rotators was measured using a handheld dynamometer, and a single-leg bridge endurance test was performed to assess differences and correlations between outcomes. Twenty-six subjects aged 18 to 35 years with rLBP (n=10) and without rLBP (n=16) participated. Statistically significant differences between the two groups were found for right and left hip flexion (p = 0.029 and 0.039, respectively), right hip adduction (p = 0.043), and right hip extension (p = 0.021). No significant differences were found between groups for strength, endurance, or other ROM measures. The findings of this study show statistically significant although clinically non-meaningful differences in hip flexion, extension, and adduction ROM in the rLBP group compared to the control group. This lack of clinically meaningful difference may be relevant to testing procedures and treatment of patients or athletes with rLBP. This study also suggests that hip strength and endurance may not play a major role in the development or treatment of rLBP. Level of Evidence: 3.

Is muscle stiffness a determinant for range of motion in the leg muscles?

Previous training studies with comprehensive stretching durations have reported that an increase in range of motion (ROM) can be related to decreases in muscle stiffness. Therefore, the purpose of this study was to analyze the association between the passive muscle stiffness of three muscle groups (triceps surae, quadriceps, hamstrings) to the respective joint ROM. Thirty-six healthy male soccer players volunteered in this study. After a standardized warm-up, the muscle stiffness was tested via shear wave elastography in six muscles (gastrocnemius medialis and lateralis, rectus femoris, semitendinosus, semimembranosus, and biceps femoris long head). The hip extension, hip flexion, and ankle dorsiflexion ROM were also assessed with a modified Thomas test, a sit and reach test, and a standing wall push test, respectively. We found significant moderate to large correlations between hip flexion ROM and muscle stiffness for the semimembranosus (rP = -0.43; P = 0.01), biceps femoris long head (rP = -0.45; P = 0.01), and overall hamstring stiffness (rP = -0.50; P < 0.01). No significant correlations were found for triceps surae (rP = -0.12; P = 0.51 to 0.67) and rectus femoris muscle stiffness (rP = 0.25; P = 0.14) with ankle dorsiflexion and hip extension ROM, respectively. We conclude that muscle stiffness is an important contributor to hip flexion ROM, but less important for hip extension or ankle joint ROM. Additional contributors to ROM might be tendon stiffness or stretch/pain tolerance.

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&lt;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.

Does a Single Session of Cupping Therapy Increase Range of Motion in Individuals With Limited Hamstring Flexibility? A Critically Appraised Topic

Context: Improving hamstring tightness is a common therapeutic goal to maintain performance and reduce injury risk. How effective is a single session of therapeutic cupping on improving hamstring flexibility? Methods: PubMed was searched in the Summer of 2023 using the search terms: cupping and range of motion (ROM). Included studies were intervention studies that evaluated cupping and flexibility within the lower extremity during a single treatment session. Hip flexion ROM was measured with the passive or active straight leg test. Means, SDs, 95% CI, and effect sizes were calculated. Results: Three articles were screened. Warren et al. reported a statistically significant increase in ROM from pre- to posttest of 4.42° using a digital inclinometer during the passive straight leg test. However, this is below a reported minimal detectable difference for the passive straight leg test (10°). Schafer et al. and Williams et al. reported no significant cupping effect over time between groups. Conclusions: There is consistent evidence that a single session of cupping therapy does not increase lower-extremity ROM in patients with limited hamstring flexibility.

Comparison of effectiveness of lower extremity axial distractor and traction table assisted closed reduction and intramedullary nail fixation in femoral subtrochanteric fracture

To compare the effectiveness of lower extremity axial distractor (LEAD) and traction table assisted closed reduction and intramedullary nail fixation in treatment of femoral subtrochanteric fracture. The clinical data of 117 patients with subtrochanteric fracture of femur treated by closed reduction and intramedullary nail fixation between May 2012 and May 2022 who met the selection criteria were retrospectively analyzed. According to the auxiliary reduction tools used during operation, the patients were divided into LEAD group (62 cases with LEAD reduction) and traction table group (55 cases with traction table reduction). There was no significant difference in baseline data, such as gender, age, injured side, cause of injury, fracture Seinsheimer classification, time from injury to operation, and preoperative visual analogue scale (VAS) score, between the two groups ( P>0.05). Total incision length, operation time, intraoperative blood loss, fluoroscopy frequency, closed reduction rate, fracture reduction quality, fracture healing time, weight-bearing activity time, and incidence of complications, as well as hip flexion and extension range of motion (ROM), Harris score, and VAS score at 1 month and 6 months after operation and last follow-up were recorded and compared between the two groups. There were 14 cases in the LEAD group from closed reduction to limited open reduction, and 43 cases in the traction table group. The incisions in the LEAD group healed by first intention, and no complication such as nerve and vascular injury occurred during operation. In the traction table group, 3 cases had perineal crush injury, which recovered spontaneously in 1 week. The total incision length, operation time, intraoperative blood loss, fluoroscopy frequency, and closed reduction rate in the LEAD group were significantly better than those in the traction table group ( P<0.05). There was no significant difference in the quality of fracture reduction between the two groups ( P>0.05). Patients in both groups were followed up 12-44 months, with an average of 15.8 months. In the LEAD group, 1 patient had delayed fracture union at 6 months after operation, 1 patient had nonunion at 3 years after operation, and 1 patient had incision sinus pus flow at 10 months after operation. In the traction table group, there was 1 patient with fracture nonunion at 15 months after operation. X-ray films of the other patients in the two groups showed that the internal fixator was fixed firmly without loosening and the fractures healed. There was no significant difference in fracture healing time, weight bearing activity time, incidence of complications, and postoperative hip flexion and extension ROM, Harris score, and VAS score at different time points between the two groups ( P>0.05). For femoral subtrochanteric fracture treated by close reduction and intramedullary nail fixation, compared with traction table, LEAD assisted fracture reduction can significantly shorten the operation time, reduce intraoperative blood loss and fluoroscopy frequency, reduce incision length, effectively improve the success rate of closed reduction, and avoid complications related to traction table reduction. It provides a new method for good reduction of femoral subtrochanteric fracture.

A Femoral Neck Osteotomy for the Patients with Ankylosing Spondylitis and Thoracolumbar Kyphosis Combined with Hip Flexion Contracture.

The surgical treatment of patients with ankylosing spondylitis and severe thoracolumbar kyphosis combined with hip flexion contracture is very difficult for all the surgeons. The femoral neck osteotomy (FNO) is the first step to break the ice. The evaluation of a new modified FNO method is very important to improve the curative effect. Five male patients with nine bone-fused hips who underwent the new femoral neck osteotomy were included from October 2021 to March 2022. The FNO was designed that the saw blade was manipulated from the lateral femoral neck base to the inferior part of the femoral head, keeping Pauwels' angle less than 30° on the coronal plane. On the transverse plane, the angle between the saw blade and the coronal plane was more than 15°. On the sagittal plane, the saw blade cut through the femoral neck. They accepted pedicle subtraction osteotomy (PSO) after FNO according to the patient' recovery. Then, 2 weeks later, the patients underwent total hip arthroplasty (THA). The visual analogue scale (VAS), Harris hip score (HHS) and passive hip flexion-extension range of motion (ROM) were used to evaluate hip function. The data were analyzed by paired t-test. The average operation time and blood loss of FNO, the average interval between FNO and THA were collected. The average angle of the trunk and lower limb (ATL) was 36.33° ± 16.36° pre-FNO, 82.89° ± 13.51° post-FNO and 175.22° ± 3.42° post-THA. The average VAS scores were 0 pre-FNO, 5 ± 1.58 post-FNO and 2.6 ± 0.55 post-THA. The average HHS was 43.56 ± 1.59 preoperatively and 83.89 ± 2.21 postoperatively. The average hip extension ROM was 23.89° ± 12.69° pre-FNO, -22.67° ± 14.18° post-FNO and - 3.33° ± 2.50 post-THA°. The average hip flexion ROM was 23.89° ± 12.69° pre-FNO, 35.56° ± 12.11° post-FNO and 104.44° ± 5.27° post-THA. The differences among them were significant (p < 0.05). Only one hip (11.11%) displaced completely after FNO. A new modified FNO was developed, which can provide osteotomy with a certain degree of stability and greater ease for performing PSO and THA.

Spatiotemporal and kinematic gait analysis in patients with knee osteoarthritis and femoral varus deformity

BackgroundKnee osteoarthritis (OA) is commonly combined with the presentation of a coronal deformity of the knee. The bony origin of the knee varus deformity can be classified as tibial origin, femoral origin, or a combination of tibial and femoral causes. Deformities of tibial origin are mostly common clinically, while patients with knee OA with femoral varus deformity are less common. Research questionDo hip, knee and ankle kinematics and spatiotemporal parameters differ between patients with knee OA with femoral varus deformity and healthy subjects? MethodsTwenty-five patients (14 females and 11 males) with knee OA and femoral varus deformity and 20 healthy subjects (12 males and 8 females) as control group were included in this study. The kinematic parameters of the hip-knee-ankle joint and spatiotemporal gait parameters were included in the study. ResultsThis study found that the step speed and step length of the knee OA with femoral varus (KOAF) group were smaller than those of the control group, while double support period percentage was greater in the KOAF group. Significant differences were found in the maximum knee extension angle, maximum knee flexion angle, knee flexion range of motion, maximum hip flexion angle, maximum hip extension angle, and hip flexion range of motion between the two groups. After comparing the ankle motion between the two groups, significant differences were found in the maximum eversion angle, inversion range of motion, maximum ankle abduction angle, and abduction range of motion. SignificanceKnee OA with femoral varus deformity causes adaptive changes in the kinematic parameters of hip, knee and ankle joints and spatiotemporal gait parameters to alleviate symptoms and maintain normal activity.

Relationship between preoperative hip range of motion and anxiety about dislocation after total hip arthroplasty

PurposeFollowing total hip arthroplasty (THA), anxiety about dislocation often limits patient's quality of life. However, the factors that cause anxiety about dislocation remain unclear. This study was an investigation of whether limited range of motion (ROM) at the hip before surgery is associated with anxiety about dislocation after THA. MethodsA retrospective cohort study was performed using questionnaires and medical records. Questionnaires were mailed to 796 female patients who underwent THA at our hospital between April 2015 and August 2020. The questionnaire was to be self-administered and asked participants to select their level of anxiety about dislocation during activities of daily living from the following answer choices: non-anxious, anxious, and extremely anxious. Hip ROM was measured within 3 days before surgery. The association between anxiety about dislocation and hip ROM was evaluated using logistic regression analysis after adjusting for potentially relevant factors. ResultsIn total, 513 (64.4%) patients responded to the questionnaire and were included in the analysis. Those patients who reporting feeling extremely anxious about dislocation after THA had limited hip flexion ROM. This association was independent of surgical approach and postoperative follow-up duration. A ROM of less than 80° during hip flexion was used to identify those respondents who reported extreme anxiety about dislocation. ConclusionThe results of this study suggest that patients with a limited hip flexion ROM before THA may be extremely anxious about dislocation after THA.

Poster 214: The Effect of Femoral Retroversion on Hip Range of Motion – A 3D Computational Analysis

Objectives: A subset of patients undergoing hip arthroscopy suffers from persistent pain and dysfunction which can be secondary to a number of factors. Femoral rotational deformities are often overlooked and/or providers are unsure when to address femoral deformities. Currently, there is limited to no data guiding surgeons when to consider a femoral osteotomy at the time of hip arthroscopy for FAI. Through previously validated computer-assisted 3D modeling software, this study sought to answer two questions: 1) How much femoral retroversion is too much to render cam femoroplasty ineffective in improving range of motion (ROM)? 2) In the setting of an osteotomy, what degree of femoral version correction would be sufficient to improve impingement free ROM? Methods: Ten patients were selected with symptomatic focal cam impingement lesions who underwent hip arthroscopy and had pre- and post-operative computed tomography (CT) scans. These patients were screened for normal acetabular morphology and demonstrated no radiographic signs of osteoarthritis. Pre- and post-operative 3D modeling of the involved hip was performed and subsequently dynamized with the femoral version set at (15, 5, -5 and -15 degrees) to define the impingement free ROM and location of impingement with maximum hip flexion and maximum hip internal rotation (IR) at 90 degrees of hip flexion. Results: Mean alpha angle pre and post cam resection were 66°±7.6 ° and 44°±4.9° respectively and were significantly different (p=0.003). Location of impingement shifted during hip flexion from the medial to anterior femoral neck with decreasing femoral version while the IR impingement location remained on the anterior femoral neck and was unaffected by femoral version. Kruskal-Wallis testing demonstrated decreasing femoral version significantly decreased hip flexion and IR ROM in both the pre and post cam resection groups (p&lt;0.0003). Impingement free ROM, as defined by hip flexion and IR greater than 90° and 10° respectively, was only identified in the 5 and 15 degree femoral anteversion models irrespective of whether cam femoroplasty had been performed. In the post cam resection group, hip IR ROM was significantly less with any level of decreasing femoral version (p&lt;0.002) while hip flexion ROM was significantly less with any level of decreased femoral version when compared to 15 degrees of anteversion (p&lt;0.04). When assessing the degree of change in ROM between the pre and post cam resection groups, femoral version had contrasting effects on hip ROM with decreasing femoral version showing less improvement with hip IR ROM while the femoral retroversion models had significantly greater improvements in hip flexion ROM when compared to the 15 degree anteversion model (p=0.02). Conclusions: Decreasing femoral version demonstrates significantly decreased hip flexion and IR both in the presence and absence of a CAM lesion. After cam femoroplasty, any level of decreased femoral version has a significant effect on hip ROM when compared to normal femoral anteversion. Femoral version seems to be the predominant factor in determining the amount of hip IR ROM in flexion and to a certain extent hip flexion ROM irrespective of the cam FAI. Impingement free ROM was only identified within the femoral anteversion models even after cam femoroplasty suggesting that recurrent mechanical collision and intra-articular damage seen with FAI may still be present with any level of true femoral retroversion. This study provides insight into the changes in hip flexion and IR that can be expected following both cam resection and simulated femoral osteotomy. [Table: see text]

Measurement of the normal contralateral hip flexion angle and posterior pelvic tilt angle using a pelvic guide pin in total hip arthroplasty

BackgroundWe aimed to measure the posterior pelvic tilt angle at maximum hip flexion and hip flexion range of motion at the femoroacetabular joint using a pelvic guide pin and to examine the difference in flexion range of motion when determined by a physical therapist and under anesthesia. MethodsData of 83 consecutive patients undergoing primary unilateral total hip arthroplasty were assessed. Using a pin inserted into the iliac crest to define the cup placement angle under anesthesia before and after total hip arthroplasty, the posterior pelvic tilt angle was determined as the change in pin tilt from the supine position to maximum hip flexion. Flexion range of motion under anesthesia was calculated as the difference in the angle between the trunk and thigh at maximum flexion and the posterior pelvic tilt angle. Flexion range of motion with a fixed pelvis measured preoperatively by a physical therapist was compared to that under anesthesia. A goniometer was used for all measurements and the number of measurements was one. FindingsMean posterior pelvic tilt angle of the pin inserted into the pelvis under anesthesia was 15.8° ± 5.3° (3°–26°) preoperatively and 12.1° ± 4.9° (3°–26°) postoperatively. Mean flexion range of motion under anesthesia was 109.4° ± 6.9° (88°–126°) and that measured by a physical therapist was 101.1° ± 8.2° (80°–120°); the difference was significant (9.7°; p < 0.01). InterpretationThese results highlight the difficulty in accurately determining hip flexion angles without the use of special devices and may help surgeons and physical therapists recognize and address this issue.

Differences in joint angles during pole vaulting between male pole vaulters with and without chronic low back pain

Abstract Study aim: To determine the difference in joint angles of the shoulder, hip, and trunk (angle of the upper torso and lower torso) during vaulting between male pole vaulters with and without chronic low back pain (LBP) and to examine the relationship between the range of motion (ROM) and maximum angle of the same joint during vaulting in all participants. Material and methods: This cross-sectional study included 17 male vaulters. The participants were divided into two groups (chronic LBP and control) based on their questionnaire results. Four high-speed cameras were used to record at 240 Hz from the touchdown of the last step on the run-up to the pole straight phase. The vaulter cleared the bungee bars that were set at 90% of their personal best record. The ROM of hip flexion and extension, shoulder flexion, and straight leg raise were measured. Results: There was no difference in the joint angles between the chronic LBP group and control group. In contrast, there was a significantly positive correlation between ROM and the maximum joint angle during hip extension (p = 0.01, r = 0.58). Conclusions: Insufficient hip ROM may result in compensatory motion in lumbar extension during pole vaulting.

남녀 대학생의 FMS ASLR 검사 점수와 발목 및 고관절의 가동성, 코어 안정성의 관계

This study aimed to investigate the relationships between active straight leg raise(ASLR) test scores, ankle dorsiflexion, hip flexion, and extension range of motion(ROM) and core stability of healthy college students. We recruited 48 healthy male and female college students aged 20-29 years. We measured ASLR test scores of functional movement screen(FMS), ankle and hip mobility(ROM of ankle dorsiflexion and hip flexion and extension), and core stability(strength of hip extension and abduction and muscular endurance of lumbar flexion and extension). Data was analyzed using Pearson’s correlation analyses and the significance level was set to α=.05.BR ASLR test scores correlated with dorsiflexion ROM of the ankle on the dominant and non-dominant sides for male college students(r=.690 [p=.001] and r=.499 [p=.021], respectively). The same correlation was found for the dominant and non-dominant sides of female college students(r=.602 [p=.001] and r=.624 [p=.001], respectively). The correlations between ASLR test scores and dorsiflexion ROM of the ankle on the dominant and non-dominant sides of all participants were r=.408(p=.004) and r=.367(p=.011), respectively. The correlations between ASLR test scores and flexion ROM of the hip joint on the dominant and non-dominant sides for all participants were r=.519 (p=.000) and r=.517 (p=.000), respectively. Additionally, there was a significant correlation(r=-.329 [p=.024]) between the FMS ASLR test scores and strength of hip extension for all participants.BR These results show that the FMS ASLR test scores correlate with dorsiflexion mobility of the ankle for male college students, and with hip flexion mobility for female college students. FMS ASLR test scores did not have a consistently significant relationship with core stability. Therefore, caution is required in the interpretation of the FMS ASLR test scores of healthy young college students aged 20-29 years.

EFFECTIVENESS OF SLIDER AND TENSIONER NEURODYNAMIC MOBILIZATION TECHNIQUES COMPARED TO STRETCHING EXERCISES ON PAIN, FUNCTION, AND RANGE OF MOTION IN PATIENT WITH CHRONIC DISCOGENIC SCIATICA

Objective: To compare the effectiveness of the slider, tensioner neurodynamic mobilization techniques and stretching exercises on pain, range of motion (ROM), and functional disability in patients with chronic discogenic sciatica. Design: A pre-test post-test multi arm parallel RCT. Setting: Outpatient clinics, faculty of physical therapy, Kafrelsheikh University. Participants: Thirty-six patients with unilateral chronic discogenic sciatica were randomly allocated into three equal groups: Group (A) slider neurodynamic mobilization, Group (B) tensioner neurodynamic mobilization, and Group (C) stretching exercises of back extensors, hamstrings, and gastrocnemius muscles. Treatment was given three sessions per week for two weeks. Outcome measures: All patients were examined by visual analogue scale (VAS) for pain intensity, Modified-Modified Schober test (MMST) for lumbar flexion ROM, goniometer for hip flexion and knee extension ROM, and Oswestry Disability Index (ODI) for functional assessment. Results: There were no statistically significant differences between groups at baseline ([Formula: see text] 0.05). There were statistically significant differences in the slider and tensioner groups compared to the stretching group for all variables. Furthermore, statistically significant differences were found in the slider technique as compared to the tensioner technique regarding ROM of lumbar flexion ([Formula: see text] = 0.03), hip flexion ([Formula: see text] = 0.004), and knee extension ([Formula: see text] = 0.005). Conclusion: Slider and tensioner neurodynamic mobilization techniques are more effective than stretching exercises in terms of reducing pain, increasing ROM, and improving function. Slider technique is more effective in ROM improvement.

Effects of cathodal transcranial direct current stimulation on hip range of motion of healthy sedentary women: A crossover study

The improvements in range of motion (ROM) by cathodal transcranial direct current stimulation (c-tDCS) were only found in sedentary men and not in females. Thus, the study investigated the effect of c-tDCS on hip flexion range of motion (HFROM) in sedentary women. Ten healthy (27.2 ± 6.4 years for age, 67.9 ± 17.8 kg for body mass, 159.1 ± 7.1 cm for height, and 87.1 ± 3.3° for HFROM) and right-leg-dominant women performed a counterbalanced crossover design in two experimental sessions, separated a week apart: c-tDCS and placebo stimulus (sham). Before and after experimental conditions (Pre-stimulation, Post-stimulation), participants had their HFROM measured. A significant interaction was demonstrated for conditions × time (F(1, 9) = 10.666; ƞ2 = 0.542; p = 0.01), indicating an increase in HFROM in the post-condition (89.0 ± 2.6°) compared to pre-condition (86.5° ± 2.9°) only in the c-tDCS. However, the HFROM improvements varied from 0.3 % to 6.5 % following c-tDCS. This study suggests that c-tDCS applied over the sensorimotor cortex of healthy sedentary women can acutely improve HFROM, but with a low percentage increase.

Characteristics of Biomechanical and Physical Function According to Symptomatic and Asymptomatic Acetabular Impingement Syndrome in Young Adults.

Femoroacetabular impingement (FAI) is caused by hip joint anomalies. Although asymptomatic and symptomatic FAI have been reported in young adults, information on biomechanical and functional characteristics of FAI is rare. We compared the subjective hip score, range of motion (ROM), dynamic balance, and hip strength between symptomatic FAI (FAIsym) and asymptomatic FAI (FAIasym) groups and healthy controls. Participants (n = 307; men: 155, women: 152) were classified according to morphological abnormalities and hip joint symptoms, comprising symptomatic FAI, asymptomatic FAI, and healthy controls. The Copenhagen Hip and Groin Outcome Score (HAGOS), hip ROM, Y-balance test (YBT), and isokinetic hip strength were measured. The types of FAI were not significantly differenent in both men and women. FAIsym exhibited significantly reduced HAGOS, whereas FAIasym showed no significant difference compared to the healthy group (men: healthy 91.7 vs. FAIasym 87.2 vs. FAIsym 49.9, women: healthy 91.7 vs. FAIasym 86.2 vs. FAIsym 53.9). Hip flexion, adduction, and internal and external rotation ROMs were only significantly reduced in symptomatic FAI. Asymptomatic and symptomatic FAI groups displayed significantly lower YBT scores than healthy controls (men healthy: 84.9 vs. FAIasym: 69.0 vs. FAIsym 58.7, women healthy 79.2 vs. FAIasym 64.0 vs. FAIsym 55.5). Isokinetic hip flexion, adduction, and abduction strengths were significantly lower in FAIsym. In conclusion, FAIasym showed no decrease in muscle strength but displayed reduced dynamic balance. Subjective satisfaction, ROM, muscle strength, and dynamic balance were lower in FAIsym compared to FAIasym and healthy groups.

Ankylosing Spondylitis Patients Have Lower Risk of Dislocation Following Total Hip Arthroplasty Compared with Patients Undergoing Lumbar Spinal Fusion Surgery.

PurposePatients undergoing lumbar spinal fusion (LSF) surgery and patients with ankylosing spondylitis (AS) have concomitant pathology of hip and lumbosacral spine. The purpose of our study is to compare the dislocation rate following total hip arthroplasty (THA) between patients with LSF and AS and reveal the differences of lumbar fusion secondary to LSF and AS.Patients and methodsFifty-nine patients (73 hips) were included in Group LSF and every patient was matched with two patients in Group AS. Follow-ups were conducted for information of surgical prognosis and dislocation events following THA. Multiple anatomic parameters were measured on preoperative and postoperative radiological images.ResultsThe dislocation rate of patients in Group AS (0.68%) was obviously lower than that of patients in Group LSF (4.11%) and the hazard ratio of dislocation events following THA reached 6.1. Considering the low calculated power (1-β, 0.24), we supposed insufficient statistical evidence (p=0.118) could be attributed to small sample size. Postoperative hip flexion range of motion (ROM) in Group AS (102.1°±24.5°) was significantly lower than that in Group LSF (117.4°±14.2°) (p<0.0005). Postoperative flexion ROM of lumbar was also significantly lower in Group AS (p<0.001). There was no significant difference between two groups concerning postoperative acetabular inclination (p=0.988) and anteversion (p=0.25). However, patients in Group AS had a significantly lower sacral slope (p=0.025) and higher pelvic tilt (p<0.0005) than patients in Group LSF after THA.ConclusionPatients with AS have a lower risk of dislocation after THA compared with patients undergoing LSF. The lower risk is significantly relevant to severer stiffness and lower mobility along the spine–pelvis-–hip axis in AS patients after THA. Acetabular orientation has no significant effect on the difference of dislocation rate between patients with LSF and AS.