Isometric Hip Adduction Research Articles

Relationship among maximum hip isometric strength, hip kinematics, and peak gluteal muscle force during running

ObjectiveTo determine if there is a relationship among isometric hip strength, hip kinematics, and peak gluteal muscle forces in cross-country runners during running. DesignCross Sectional. SettingUniversity Biomechanics Laboratory. ParticipantsForty-six NCAA Division III collegiate cross-country runners (18 males, 28 females). Main outcome measuresPearson correlation coefficients were used to describe relationships among isometric hip strength, hip kinematics, and peak gluteal muscle forces during the stance phase of running. Strength of correlations were interpreted as little to no relationship (r < 0.25), fair relationship (0.25 ≤ r < 0.5), moderate relationship (0.5 ≤ r < 0.75), and strong relationship (r ≥ 0.75). Correlations were considered significant if p < 0.05. ResultsLittle to no relationships were found among isometric hip strength and gluteal muscle forces during running (r < 0.25). A fair relationship was present between prone external rotation isometric hip strength and peak hip adduction (0.25 <r < 0.5). Little to no relationship was shown between gluteus medius force and hip internal rotation. Moderate relationships were present among peak gluteus medius and minimus muscle forces and peak hip adduction (0.5 <r < 0.75). ConclusionIsometric hip strength does not appear to be related to gluteal muscle forces and hip kinematics during the stance phase of running while gluteal muscle force was moderately related to hip adduction. Factors other than strength may be related to muscle force production and hip kinematics during running.

Weak associations between hip adduction angle and hip abductor muscle activity during running

Hip abductor muscle strengthening is often prescribed to reduce the peak hip adduction angle in runners with overuse knee injury. However, no evidence exists associating greater isometric hip abductor muscle strength with smaller peak hip adduction angle during running. Beyond muscle strength, muscle activation patterns may play an important role in controlling joint movement during running. Therefore, the purpose of this investigation was to determine if associations existed among hip adduction angle, hip abductor muscle activity, and isometric hip abductor muscle strength. Twenty-five currently healthy female runners participated. Average gluteus medius muscle activity and tensor fascia lata muscle activity were determined during hip abductor maximal voluntary isometric contractions. Three-dimensional kinematics and hip abductor muscle activity were collected during treadmill running. Dependent variables were analyzed via Pearson product moment correlations. Multi-variable linear regression determined muscle activity’s and strength’s contributions to the peak hip adduction angle. A fair positive correlation was observed between the peak hip adduction angle and average tensor fascia lata muscle activity magnitude. Additionally, there was a moderate negative correlation between isometric hip abductor muscle strength and average gluteus medius muscle activity magnitude. Tensor fascia lata activity magnitude accounted for the most variance of the peak hip adduction angle. This study adds to the literature which indicates a lack of association between isometric hip abductor muscle strength and peak hip adduction angle in healthy runners. Factors other than hip abductor muscle strength and activation may account for more of the variance in peak hip adduction angles among runners.

THE INFLUENCE OF HIP JOINT ANGLE ON THE RATIO BETWEEN ADDUCTION AND ABDUCTION TORQUE IN EXPERIENCED, RECREATIONAL MALE ICE HOCKEY PLAYERS

Strains of the adductor muscle group of the hip are common amongst ice hockey players. The ratio of isometric strengths between the hip adductors and abductors has been offered as a risk factor for hip adductor strain; however, there is no description for how the ratio between hip adductor and abductor strength varies as a function of hip abduction angle. The aim of this study was to determine the influence of hip joint abduction angle on measured ratios of hip adduction to abduction torque in experienced, recreational, male hockey players. The primary null hypothesis for this study was that hip joint abduction angle would not influence hip adduction-to-abduction torque ratios in male hockey players. Counterbalanced observational cohort. Twelve uninjured, male, recreational hockey players, with a minimum experience level of midget AAA/minor competitive or equivalent. Participants performed maximal isometric side-lying hip adduction and abduction exertions against a rigidly constrained load cell at 0, 10, and 20 degrees of hip abduction. Measured peak torques from each exertion were used to derive the hip adductor-to-abductor torque ratio. Kinematics of the trunk, pelvis, and lower limbs were monitored using an optoelectronic motion capture system. Adductor-to-abductor torque ratio increased from 1.49 (SD = 0.20), to 1.92 (SD = 0.20) and to 2.30 (SD = 0.54) with successively increasing hip abduction angle (p < 0.001). Peak torque was significantly different between all angles (p ≤ 0.016) except between adduction exertions performed at 10 and 20 degrees of abduction (p = 0.895). Small changes in hip angle during the exertion were coincident with exertion direction, which confirmed the isometric nature of the task. Hip abduction angle has a significant impact on the measured adductor-to-abductor torque ratio. The ratio increased due to a combination of increased adductor torque and decreased abductor torque as the hip abduction angle increased. 2b.

The influence of a badminton competition with two matches in a day on muscle damage and physical performance in elite junior badminton players.

To investigate the effects of a badminton competition with 2 matches in a day on hip strength and range of motion (ROM) and exercise-induced muscle damage in elite junior badminton players. Twenty players (age: 17±0.8 years; body mass: 62.9±6.5 kg, height: 173.8±8.9 cm) participated in this study. Passive hip internal (IR) and external rotation (ER), abduction (ABD) and adduction (ADD) hip ROM, isometric hip ADD and ABD muscle strength, countermovement vertical jump (CMJ) height and blood creatine kinase concentration (CK) were measured before and after a badminton competition during an international tournament. Blood samples were collected 24 h after the end of the last match. Compared to baseline values, hip IR and ER ROM were significantly decreased at post-competition in the dominant (IR=-9.0%; p=0.007 and ER=-15.2%; p=0.002) and non-dominant limbs (IR=-9.08%; p=0.004 and ER=-19.4%; p<0.001). In contrast, hip ADD (13.5%; p<0.001) and ABD (14.6%; p<0.001) strength increased significantly after the competition in the dominant limb and ABD strength increased significantly in the non-dominant limb (9.2%; p=0.001). From baseline values, CK increased after the competition (430.1%) and values remained elevated over baseline values 24 h later (160.4%). Although hip muscle strength increased, a badminton competition with two consecutive matches reduced hip ROM and increased blood CK concentration. This study suggests the necessity of investigating recovery strategies after a badminton competition to return hip ROM to basal values before the next day of the competition.

Absolute and Allometrically Scaled Lower-Limb Strength Differences Between Children With Overweight/Obesity and Typical Weight Children.

Theis, N, Le Warne, M, Morrison, SC, Drechsler, W, and Mahaffey, R. Absolute and allometrically scaled lower-limb strength differences between children with overweight/obesity and typical weight children. J Strength Cond Res 33(12): 3276-3283, 2019-The purpose of this study was to compare isometric and isokinetic hip, knee, and ankle strength in children with overweight/obesity (OWB) and typical weight (TW) of age 6-12 years. Absolute torque and torque allometrically scaled to body mass and fat-free mass were derived to allow for comparison of strength irrespective of body size. Using a cross-sectional design, 26 OWB (body mass index [BMI] Z score: 2.28 ± 0.77, 54% females) children were matched in age and height with 26 TW (BMI Z score: -0.39 ± 0.96, 54% females). Subjects performed maximal isometric and isokinetic contractions in ankle dorsiflexion and plantarflexion, knee flexion and extension, hip flexion and extension, and isometric hip abduction and adduction. Between-group differences in absolute and normalized isometric and isokinetic strength were compared with 1-way analysis of variances. Statistical significance was set at p < 0.05. Children with OWB had significantly greater absolute torque in the knee flexors and extensors (15-21%) and greater isokinetic ankle dorsiflexion (8%) but lower isometric hip abduction (21%) compared with TW children. When strength was allometrically scaled to body mass, children with OWB were significantly weaker at the ankle (19-25%), hip (21-36%), and in the knee extensors (12-15%). When torque was allometrically scaled to fat-free mass, children in the OWB group had greater knee flexor and extensor strength (12-14%) but were weaker in isometric hip abduction (33%) and isokinetic hip flexion and extension (29-40%). The results demonstrated that deficits in strength, relative to body mass, at the ankle and hip may be greater than those of the knee. These strength deficits in the group with OWB highlight the need for targeted musculoskeletal strength interventions to incorporate all lower-limb muscle groups.

Lower limb musculoskeletal screening in elite female Australian football players

ObjectiveTo report physical characteristics of lower-limb strength, endurance, range of motion, balance, and pain during adductor squeeze in elite female Australian Football (AF) players, and to examine the effect of limb dominance, previous AF experience, age, and previous level of sports participation on these characteristics. DesignCross-sectional study. SettingThree elite AF clubs. ParticipantsEighty-five female players. All were aged ≥18, contracted for the 2018 season, and participated in pre-season training. Main outcome measuresThe physical characteristic assessments included; pain on adductor squeeze, weight-bearing lunge, side bridge, isometric hip abduction and adduction strength, and the modified star excursion balance test. ResultsThe adductor squeeze had low pain scores, with 93% of players scoring ≤2 on the numerical rating scale. Other assessment results were (mean ± SD): 10.8 ± 2.7 cm for weight-bearing lunge, 95 ± 39s for side bridge, 1.85 ± 0.23 and 1.85 ± 0.36Nm/kg for hip abduction and adduction strength respectively, and 92 ± 8% for the modified star excursion balance test. There was no clinically relevant effect of limb dominance, previous AF experience, age, or previous level of sports on physical characteristics. ConclusionsPhysical characteristics for five assessments are reported. These data can be used for comparison purposes in the screening and clinical management of elite female AF players.

Hip adduction and abduction strength and adduction-to-abduction ratio changes across an Australian Football League season

ObjectivesPre-season hip strength testing only represents the athlete’s level of conditioning at that time point, and may change over an Australian Football (AF) season. This study aimed to examine if there are changes in hip adduction, abduction and the adduction-to-abduction ratio between preferred and non-preferred kicking legs throughout an AF season. The influence of training load and player characteristics was also examined. DesignCross-sectional repeated measures. Methods38 uninjured elite AF players were included. Maximal isometric hip adduction and abduction strength were measured at four time points: start of pre-season (T1), end of pre-season (T2), mid-season (T3) and post-season (T4) using a hand held dynamometer with external belt fixation. ResultsHip adduction strength and hip-adduction-to-abduction ratio were greater in T3 compared to T1 (adduction by 22.71N, p<0.001, ratio by 0.15N, p<0.001) and hip adduction and abduction were weaker in T4 compared to T1 (adduction by 18.6N, p=0.004, abduction by 24.67N, p<0.001). No differences were found between the preferred and non-preferred leg in adduction (p=0.409) or abduction (p=0.602) strength. There was an interaction between leg and time point for the adduction-to-abduction ratio; at T3 and T4, the ratio of the preferred kicking leg was significantly lower than the non-preferred kicking leg (T3 by 0.14N, p=0.020, T4 by 0.15N, p=0.019). Training load was not significantly associated with strength changes. ConclusionsHip strength does change over an AF season. Regular in-season hip strength testing should occur to more accurately reflect player condition compared to one pre-season measurement.

A Bayesian Network approach to study the relationships between several neuromuscular performance measures and dynamic postural control in futsal players

PurposeThe purpose of this study was to analyse the relationship between several parameters of neuromuscular performance with dynamic postural control using a Bayesian Network Classifiers (BN) based analysis.MethodsThe y-balance test (measure of dynamic postural control), isokinetic (concentric and eccentric) knee flexion and extension strength, isometric hip abduction and adduction strength, lower extremity joint range of motion (ROM) and core stability were assessed in 44 elite male futsal players. A feature selection process was carried out before building a BN (using the Tabu search algorithm) for each leg. The BN models built were used to make belief updating processes to study the individual and concurrent contributions of the selected parameters of neuromuscular performance on dynamic postural control.ResultsThe BNs generated using the selected features by the algorithms correlation attribute evaluator and chi squared reported the highest evaluation criteria (area under the receiver operating characteristic curve [AUC]) for the dominant (AUC = 0.899) and non-dominant (AUC = 0.879) legs, respectively.ConclusionsThe BNs demonstrated that performance achieved in the y-balance test appears to be widely influenced by hip and knee flexion and ankle dorsiflexion ROM measures in the sagittal plane, as well as by measures of static but mainly dynamic core stability in the frontal plane. Therefore, training interventions aimed at improving or maintaining dynamic postural control in elite male futsal players should include, among other things, exercises that produce ROM scores equal or higher than 127° of hip flexion, 132.5° of knee flexion as well as 34° and 30.5° of ankle dorsiflexion with the knee flexed and extended, respectively. Likewise, these training interventions should also include exercises to maintain or improve both the static and dynamic (medial-lateral plane) core stability so that futsal players can achieve medial radial error values lower than 6.69 and 8.79 mm, respectively.

Effect of 6-week retro or forward walking program on pain, functional disability, quadriceps muscle strength, and performance in individuals with knee osteoarthritis: a randomized controlled trial (retro-walking trial)

BackgroundPrevious studies reported the beneficial effects of walking in individual with mild to moderate knee osteoarthritis (OA). The current study aimed to compare the effect of 6-week retro versus forward walking program versus control group on pain, functional disability, quadriceps muscle strength and physical performance in individuals with knee OA.MethodsA three-arm single-blinded, randomized, controlled trial and intention-to-treat analysis was conducted in outpatient physiotherapy department, King Saud University, Saudi Arabia. Sixty-eight individuals (mean age, 55.6 years; 38 female) with knee OA participated. The participants in the retro or forward walking group completed 10 min of supervised retro or forward walking training in addition to usual care, 3 days/week for 6 weeks. The control group received a routine physiotherapy program. This program comprises a combination of closed and open kinematic chain exercises, including straight leg raising, isometric quadriceps, isometric hip adduction, terminal knee extension, semi-squat, and leg press. The primary outcomes were mean pain and knee function score measured by the numerical rating scale and the Western Ontario and McMaster Universities Osteoarthritis Index, respectively. The secondary outcomes were mean score of quadriceps muscle strength and timed up and go test scores. All the outcomes were analyzed at baseline and week 6.ResultsIn total, 68 subjects participated in this 6-week randomized, controlled trial. The completion rates of the primary and secondary outcome measures at week 6 were 91, 87, and 82% in the retro walking, forward walking, and control groups, respectively. In the intention-to-treat analysis, the retro walking group had a greater reduction in pain intensity (mean changes, 1.8 versus 1; p = 0.01) and functional disability (mean changes, 4.8 versus 2.2; p = 0.008) than the control group. Similarly, the retro walking group had a greater improvement in the quadriceps muscle strength (mean changes, 1.7 kg versus 0.7 kg; p = 0.008) and the timed up and go test (mean changes, 0.6 s versus 0.1 s; p = 0.003) than the control group.ConclusionsThe 6-week retro walking program compared with forward walking or control groups resulted in greater reduction in pain and functional disability and improved quadriceps muscle strength and performance in individuals with knee OA.Trial registrationControlled Trials ISRCTN12850845, Registered 26 January 2015.

Different neuromuscular parameters influence dynamic balance in male and female football players.

To analyse the relationship between several parameters of neuromuscular performance with unilateral dynamic balance measured through the Y-Balance test, as well as to determine the possible sex-related differences. The Y-Balance test, isokinetic (concentric and eccentric) knee flexion and extension strength, isometric hip abduction and adduction strength, lower extremity joint range of motion (ROM) (hip, knee and ankle) and core stability were assessed in male (n = 88) and female (n = 44) professional football players. A stepwise multivariate linear least square regression with backward elimination analysis was carried out to identify a group of factors that were independently associated with balance performance in both sexes. Passive hip flexion and ankle dorsiflexion with knee flexed ROM were the main factors that retained a significant association to dominant (R2 = 23.1) and non-dominant (R2 = 33.5) balance scores for males. For females, core stability, hip abduction isometric peak torque, passive hip abduction and ankle dorsiflexion with knee flexed ROM variables retained a significant association with balance scores for both, dominant (R2 = 38.2) and non-dominant (R2 = 46.9) legs. Training interventions aimed at improving or maintaining unilateral dynamic balance in male football players should include, among other things, stretching exercises for the posterior chain of the lower extremity. However, females should also include exercises for strength and mobility of the hip abductors and core stability (especially in the frontal plane). This knowledge would allow clinicians and sport practitioners to develop more effective and tailored unilateral dynamic balance training interventions in male and female football players, possibly improving performance and reducing the risk of injury. III.

The Effect of Therapeutic Exercise on Long-Standing Adductor-Related Groin Pain in Athletes: Modified Hölmich Protocol.

Objective The Hölmich protocol in therapeutic exercise is the most appropriate method for the treatment of long-standing adductor-related groin pain (LSAGP). Herein, we evaluated a modified Hölmich protocol to resolve the possible limitations intrinsic to the Hölmich protocol in terms of the rate of return to sport and the recovery period for athletes with LSAGP. Design The study followed a single-blind, before/after study design, where 15 athletes with LSAGP (mean age = 26.13 years; SD = 4.48) performed a 10-week modified Hölmich therapeutic exercise protocol. Results Outcome scores related to pain, hip adductor and abductor muscle strengths, and the ratio of maximum isometric and eccentric hip adduction to abduction strength increased significantly. Likewise, hip abduction and internal rotation ROM improved significantly compared to that at baseline. Furthermore, functional records (t-test, Edgren Side Step Test, and Triple Hop Test) showed significant improvement after treatment. Finally, 13 athletes (86.6% of the participants) successfully returned to sports activity in a mean time of 12.06 weeks (SD = 3.41). Conclusion The findings of this study objectively show that the modified Hölmich protocol may be safer and more effective than the Hölmich protocol in athletes with LSAGP in promoting their return to sports activity. This trial is registered with IRCT2016080829269N1.

Effect of combined actions of hip adduction/abduction on the force generation and maintenance of pelvic floor muscles in healthy women.

Pelvic floor muscle (PFM) force and coordination are related to urinary incontinence severity and to sexual satisfaction. Health professionals frequently combine classic PFM exercises with hip adduction/abduction contraction to treat these disorders, but the real benefits of this practice are still unknown. Based on a theoretical anatomy approach whereby the levator ani muscle is inserted into the obturator internus myofascia and in which force generated by hip movements should increase the contraction quality of PFMs, our aim was to investigate the effects of isometric hip adduction and abduction on PFM force generation. Twenty healthy, nulliparous women were evaluated using two strain-gauge dynamometers (one cylinder-like inside the vaginal cavity, and the other measuring hip adduction/abduction forces around both thighs) while performing three different tasks: (a) isolated PFM contraction; (b) PFM contraction combined with hip adduction (30% and 50% maximum hip force); and (c) PFM contraction combined with hip abduction (30% and 50% maximum hip force). Data were sampled at 100Hz and subtracted from the offset if existent. We calculated a gradient between the isolated PFM contraction and each hip condition (Δ Adduction and Δ Abduction) for all variables: Maximum force (N), instant of maximum-force occurrence (s), mean force in an 8-second window (N), and PFM force loss (N.s). We compared both conditions gradients in 30% and 50% by paired t-tests. All variables did not differ between hip conditions both in 30% and 50% of maximum hip force (p>.05). PFM contraction combined with isometric hip abduction did not increase vaginal force in healthy and nulliparous women compared to PFM contraction combined with isometric hip adduction. Therefore, so far, the use of hip adduction or abduction in PFM training and treatments are not justified for improving PFM strength and endurance.

Effects of a Pelvic Belt on Hip Muscle Forces and Abdominal Muscle Activities During Isometric Hip Adduction and Abduction

Effects of a Pelvic Belt on Hip Muscle Forces and Abdominal Muscle Activities During Isometric Hip Adduction and Abduction

Hip Strength Deficits in People With Symptomatic Knee Osteoarthritis: A Systematic Review With Meta-analysis.

Study Design Systematic review with meta-analysis. Background A complete understanding of impairments associated with knee osteoarthritis would optimize exercise interventions for people with knee osteoarthritis. Our current understanding of hip strength deficits in this population is based on studies with conflicting findings and small samples. There is a need to systematically review and pool current evidence. Objectives To determine whether hip strength deficits exist in people with symptomatic knee osteoarthritis. Methods Electronic databases (MEDLINE, CINAHL, Embase, the Cochrane Library, and PsycINFO) were searched through February 2016. Studies comparing hip strength in people diagnosed with symptomatic knee osteoarthritis to healthy control participants were included in the review. A meta-analysis with random effects was applied to relevant data from included studies and a modified Grading of Recommendations Assessment, Development and Evaluation approach was used to evaluate the quality of evidence for each pooled analysis. Results Five studies were included in the review. Meta-analysis revealed moderate-quality evidence of weaker isometric and isokinetic hip abduction strength in people with knee osteoarthritis (moderate difference: 7% to 24% weaker) and very low-quality evidence of no difference in isometric hip adduction strength. There was very low- to moderate-quality evidence of weaker isokinetic hip strength in the remaining planes of motion (moderate to large differences: 14% to 55% weaker). Conclusion Significant hip strength deficits exist in people with knee osteoarthritis. Hip strength assessment should be considered in clinical practice and may assist with directing targeted management strategies. Level of Evidence Symptom prevalence, level 1a-. J Orthop Sports PhysTher 2016;46(8):629-639. Epub3 Jul 2016. doi:10.2519/jospt.2016.6618.

Comparison of EMG activity on abdominal muscles during plank exercise with unilateral and bilateral additional isometric hip adduction

The aim of this study was to investigate the effects of additional isometric hip adduction during the plank exercise on the abdominal muscles. Twenty healthy young men participated in this study. Surface electromyography (EMG) was used to monitor the activity of the bilateral rectus abdominis (RA), the internal oblique (IO), and the external oblique (EO) muscles. The participants performed three types of plank exercise; the standard plank exercise, the plank exercise with bilateral isometric hip adduction, and the plank exercise with unilateral isometric hip adduction. All abdominal muscle activity was significantly increased during the plank exercise combined with the bilateral and unilateral isometric hip adduction compared with the standard plank exercise (p<0.05). Bilateral IO, EO, and left RA muscle activity was significantly increased during the unilateral isometric hip adduction compared with the bilateral isometric hip adduction (p<0.05). These findings suggest that additional isometric hip adduction during the plank exercise could be a useful method to enhance abdominal muscle activity. In particular, the unilateral isometric hip adduction is a more beneficial exercise than the bilateral isometric hip adduction.

Hip Strength Testing of Soccer Players With Long-Standing Hip and Groin Pain: What are the Clinical Implications of Pain During Testing?

To investigate whether self-reported pain during hip strength testing correlates to a large degree with hip muscle strength in soccer players with long-standing unilateral hip and groin pain. Cross-sectional study. Clinical assessments at Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Centre Amager, Copenhagen University Hospital, Denmark. Twenty-four male soccer players with unilateral long-standing hip and groin pain. The soccer players performed 5 reliable hip muscle strength tests (isometric hip flexion, adduction, abduction, isometric hip flexion-modified Thomas test, and eccentric hip adduction). Muscle strength was measured with a hand-held dynamometer, and the players rated the pain during testing on a numerical rating scale (0-10). In 4 tests (isometric hip adduction, abduction, flexion, and eccentric adduction), no significant correlations were found between pain during testing and hip muscle strength (Spearman rho = -0.28 to 0.06, P = 0.09-0.39). Isometric hip flexion (modified Thomas test position) showed a moderate negative correlation between pain and hip muscle strength (Spearman rho = -0.44, P = 0.016). Self-reported pain during testing does not seem to correlate with the majority of hip muscle strength tests used in soccer players with long-standing hip and groin pain.

Effects of isometric hip movements on electromyographic activities of the trunk muscles during plank exercises.

[Purpose] The purpose of this study was to investigate the effect of isometric hip adduction and abduction on trunk muscle activity during plank exercises. [Subjects and Methods] Nineteen healthy male subjects were recruited for this study. All subjects performed the traditional plank exercise (TP), plank exercise with isometric hip adduction (PHAD), and plank exercise with isometric hip abduction (PHAB) by using an elastic band. Electromyographic (EMG) activities of the internal oblique (IO) and external oblique (EO) were measured during the 3 plank exercises by using an Electromyography system. [Results] Internal oblique and external oblique muscle activities were significantly greater during plank exercise with isometric hip adduction and plank exercise with isometric hip abduction than during traditional plank exercise. Internal oblique and external oblique muscle activities did not differ between the plank exercise with isometric hip adduction and plank exercise with isometric hip abduction conditions. [Conclusion] These findings demonstrate that loaded isometric hip movements may be a useful strategy to increase trunk muscle activity during plank exercises.

The effect of gluteus medius strengthening on the knee joint function score and pain in meniscal surgery patients.

[Purpose] The purpose of this study was to analyze the effect of gluteus medius activity strengthening due to squat with isometric hip adduction and hip abduction in side-lying exercise on knee joint function index and pain in meniscal surgery patients. [Subjects and Methods] This study selected sample of 26 patients who had meniscal surgery more than 4 weeks ago. The patients were divided into squat with isometric hip adduction exercise group I (n=8), hip abduction in side-lying exercise group II (n=9), and combined exercise group III. The lysholm score was used to evaluate knee joint function and visual analog scale was used to evaluate pain index of knee joint. [Results] Two-way repeated measures ANOVA was used to analyze the lysholm score and visual analog scale and showed significant interaction between the groups and durations. [Conclusion] Strengthening vastus medialis oblique and gluteus medius improved functional recovery and pain reduction of knee joint in meniscal injury surgery patients. Gluteus medius strengthening exercise is essential to meniscal injury surgery patients and should be included in rehabilitation program in early stages to be conducted systematically.

Effects of Different Types of Isometric Hip Contraction on Gluteus Medius and Tensor Fasciae Latae Activity During Squat Exercises

Hip muscle activation and strengthening exercise programs are often used to prevent and treat various lower extremity injuries. Common exercise programs include squat exercises. The purposes of this study were to investigate gluteus medius (GMED) and tensor fasciae latae (TFL) muscle activity, and to assess the GMED/TFL ratio during squat exercises involving different isometric hip contraction conditions. Different types of isometric hip contraction were standard squat without hip contraction, squats with isometric hip adduction, and squats with isometric hip abduction. Twenty (10 males and 10 females) healthy subjects (23.7±2.8 years old) were recruited. Subjects performed the squat exercises with the back supported by a wall and knees flexed to 60°. Surface electromyography (EMG) was used to measure GMED and TFL activity. One-way repeated analysis of variance was used to compare GMED and TFL muscle activity and the GMED/TFL ratio. GMED and TFL EMG activity was significantly higher during squats with isometric hip adduction and abduction compared with the standard squat without hip contraction (p<.05). Between the isometric hip adduction and abduction contraction conditions, only the TFL EMG activity was significantly higher during squats with isometric hip adduction than isometric hip abduction (p<.05). The GMED/TFL ratio was significantly higher during squats with isometric hip adduction than isometric hip abduction (p<.05). Squats with isometric hip adduction and abduction improved GMED and TFL muscle activity. Furthermore, the GMED/TFL ratio was higher during isometric hip adduction than isometric hip abduction. Our data indicate that squat exercises involving isometric hip adduction enhance GMED muscle activity.

Preferential vastus medialis oblique activation and its effectiveness in patellofemoral pain syndrome: A review of literature-an update

To review recent literature regarding evidences for best possible exercises and methods that are proposed for preferential vastus medialis oblique (VMO) activation and effectiveness of preferential VMO activation in patellofemoral pain syndrome (PFPS) patients. The review of recent literature supports preferential VMO activation as one of the efficient management protocols in PFPS patients. Although there is quite heterogeneity in the available research, a majority of research suggests close kinetic chain (CKC) exercises to be more beneficial also the CKC squatting exercise with full maximum voluntary isometric contraction hip adduction has been an exercise quite supported by the recent researches for preferential VMO activation. It can be augmented via other methods like taping, biofeedback, motor imagery, unstable surface to enhance the VMO activation. In accordance with the review of recent literature, preferential VMO activation also has been very well correlated with a reduction in pain, enhancement in function in PFPS patients.