Left Hip Abduction Research Articles

Hip and shoulder flexibility in novice rhythmic gymnasts and age-matched controls: Inter-limb asymmetry

Rhythmic gymnastics is a sport of asymmetry and lateral preferences, so the main objective of this study was to examine and compare hip and shoulder range of motion (ROM) and inter-limb asymmetry in 44 rhythmic gymnasts (RGs) and 51 age-matched non-athletes (NAs), i.e. controls. The baseline characteristics of 95 female participants, divided into two age-group categories (U8: 6–8 years, N=36; U11: 8–11 years, N=59) were established, as well as their hip (right/left hip flexion, right/left hip extension, right/left hip abduction, in °) and shoulder ROM (right/left shoulder flexion, right/left shoulder extension, in °), and asymmetry index (ASI, in %) was calculated. Significant differences between RGs and NAs were established (the exception is hip and shoulder extension in U8s, p>0.05), with greater ROM values recorded in RGs. Significant age differences were recorded among RGs in hip flexion and left hip abduction (p<0.05), in favor of U11s, and within NAs only in the case of right hip flexion (p=0.017), but in favor of U8s. The presence of asymmetries (ASI>15%), as well as its absence, is established in both RGs and NAs, but statistically significant side-to-side differences were recorded in U8 NAs (shoulder flexion, p=0.044) and U11 NAs (shoulder extension, p=0.057).

Comparisons and Associations between Hip-Joint Position Sense and Glycosylated Hemoglobin in Elderly Subjects with Type 2 Diabetes Mellitus—A Cross-Sectional Study

Hip-joint position sense (JPS) accuracy may be impaired in individuals with type 2 diabetes mellitus (T2DM). An impaired hip JPS can alter postural control and bodily balance. The objectives of this study are to (1) compare the hip JPS between T2DM and asymptomatic and (2) assess the relationship between hip JPS and glycosylated hemoglobin (HbAlc). This comparative cross-sectional study included 117 elderly individuals with T2DM (mean age: 59.82 ± 6.80 y) and 142 who were asymptomatic (mean age: 57.52 ± 6.90 y). The hip JPS was measured using a digital inclinometer. The individuals were repositioned to a target position with their eyes closed, and the magnitudes of matching errors were estimated as reposition errors. The hip JPS was evaluated in the flexion and abduction directions. The magnitude of reposition errors was significantly larger in the T2DM group in the right flexion (p < 0.001), the right abduction (p < 0.001), the left flexion (p < 0.001), and the left abduction (p < 0.001) directions compared to the asymptomatic group. HbA1c values showed a significant positive correlation with JPS in the right-hip flexion (r = 0.43, p < 0.001), the right-hip abduction (r = 0.36, p < 0.001), the left-hip flexion (r = 0.44, p < 0.001), and the left-hip abduction (r = 0.49, p < 0.001) directions. Hip JPS testing may be considered when assessing and formulating treatment strategies for individuals with type 2 diabetes. Future research should focus on how hip JPS can impact balance and falls in individuals with T2DM.

Double Diapering Ineffectiveness in Avoiding Adduction and Extension in Newborns Hips.

Hip flexion and abduction is fundamental for developmental dysplasia of the hip (DDH) treatment. At present, double diaper treatment has been inappropriately adopted when DDH is suspected. The aim of this study was to verify whether double diapers influence a newborn’s hip position. Here, we studied 50 children (23 female; 27 male; average age 62.33 ± 20.50 days; average birth weight 3230 ± 447 g) with type I hips according to Graf. At the same time of the ultrasound (US) examination, the following hip positions were measured using a manual protractor: (1) spontaneous position, supine on the outpatient bed without a diaper; (2) spontaneous position, with a double diaper; and (3) squatting position on the caretakers’ side. Statistical analysis was performed with a t-test to compare between (1) the spontaneous position without a diaper and with double diapers; (2) the spontaneous position with double diapers as well as the squatting position on the caretakers’ side with a diaper. The comparison between the hip position without diaper and with double diapers was statistically not significant for all measurements, i.e., right hip flexion (p < 0.33), left hip flexion (p < 0.34), and right and left hip abduction (p < 0.87). The comparison between the hip position with double diapers and on the caretakers’ side was statistically significant for all measurements, i.e., right hip flexion (p < 0.001), left hip flexion (p < 0.001) and right and left hip abduction (p < 0.001). We found that the use of double diapers did not affect hip position, while the position formed on the caretaker’s side shows favorable influence.

Comparison of Center of Pressure and Kinematic Differences in Grand Plié With and Without the Barre.

The purpose of this study was to determine what differences exist when performing grand plié with and without the barre. Differences in center of pressure (COP) sway, trunk kinematics, and lower extremity kinematics were used in this analysis for both first (P1) and fifth positions (P5). It was hypothesized that use of the barre would result in decreased COP sway, but increased asymmetries in trunk and lower extremity kinematics would be seen compared with the same movements performed without the barre in both positions. Sixteen collegiate dancers (1 male, 15 female) performed three trials of grand plié in P1 and P5 (right leg crossed in front) with or without the barre, for a total of 12 trials. For the barre condition (BC), participants demonstrated less time to complete grand plié, slightly less depth in grand plié, and decreased anterior-posterior (AP) sway compared to the without barre condition (WBC). The BC condition showed increased peak left trunk rotation, right knee flexion, decreased right and left peak hip flexion, and increased right hip abduction in both P1 and P5. Comparing P1 to P5, there was decreased AP sway, decreased peak left trunk rotation, decreased peak right and left hip flexion, increased left hip abduction, and decreased right knee flexion in both BC and WBC conditions. For the BC, there was increased right hip abduction in P1 compared to P5. Our results indicate that while use of the barre provides proprioceptive information, which helps dancers to control balance and learn a motor control strategy, grand plié should also be taught without the barre to challenge the dancer's balance control with different movement patterns in space.

Sample Entropy Analysis Of Dance Interventions In People With Parkinson’s Disease And Older Adults

Dance comprises a broad range of techniques and styles, which have been utilized in classes specifically designed for individuals with Parkinson’s disease (PD) and healthy older adults (OA). Previous studies have shown that a series of dance sessions can improve balance, posture, and gait for people diagnosed with PD and healthy older adults. However, these studies have not analyzed the features of body limb movement during dance. Sample Entropy (SamEn) analysis can be used to examine the complexity of movements in order to provide direction in the development of optimal dance interventions for these populations. PURPOSE: To identify dance movement patterns resulting in the greatest improvement in tests of gait, balance and upper extremity function using partnered and non-partnered dance to music in PD and OA. We hypothesize that entropy-driven variation in movement will enhance improvements in motor performance and that PD participants will show greater sample entropy during dance than OA participants. METHODS: Participants with and without PD participating in structured group dance classes were recruited for this study. Motion capture was used to examine movement patterns and sample entropy analysis was used to calculate the complexity of movements during dance. RESULTS: Participants with PD had a greater spread of SamEn in left hip abduction during tango movements than right hip abduction (p < 0.0001). A greater SamEn in right hip rotation during tango movements than left hip rotation (p < 0.0001) was seen during tango but no significant difference during foxtrot. Furthermore, PD group had no significant difference in left/right knee flexion SamEn during tango but left knee flexion SamEn was higher during foxtrot than right knee flexion SamEn (p = 0.006). OA participants saw a much smaller, but still significant, spread in SamEn in left hip abduction during Tango than right hip abduction (p = 0.002), with no significant difference in hip rotation SamEn. CONCLUSION: We interpret our entropy results as showing a decrease in PD left hip abduction control compared to the right hip during tango. Our PD participants reported that the left side was more affected. These types of data could be used to optimize dance interventions in regards to dance type, music beat/rhythm in order to improve limb control.

Reliability of a portable fixed frame dynamometry system used to test lower limb strength in elite Australian Football League players

ObjectivesDeficits in strength of lower limb musculature have been associated with increased injury risk in a variety of athletic populations. As medical and performance staff seek to better understand the association between hip and knee strength measures and injury risk, measurement tools with high reliability and utility are required to profile and manage athletes effectively. The purpose of this study was to investigate the test-retest reliability of a portable fixed frame dynamometry system used to assess hip and knee strength of an elite Australian Football League team. DesignCase series. MethodsMaximum voluntary isometric strength of the hip abductors, hip adductors and knee flexors of 41 elite male Australian Football League footballers (mean age=23.7±4.1 years, height=189.2±7.0cm, weight=88.6±8.4kg) were tested during preseason training. Tests were performed one week apart on the same training day of a standard preseason week. ResultsTest-retest reliability was very high for left hip adduction (ICC 0.958), right hip adduction (ICC 0.955), left hip abduction (ICC 0.957), right hip abduction (ICC 0.945), left knee flexion (ICC 0.927) and right knee flexion (ICC 0.923). Furthermore, standard errors of measurement in per cent (SEM%) ranged from 3.21 to 5.03%, and minimal detectable change (MDC) from 3.93 to 6.65kg for the different hip and thigh strength measures, making it possible to determine small changes in strength at the individual level. ConclusionsThis study demonstrated very high reliability when testing maximal voluntary isometric hip and knee strength using a portable fixed dynamometry system (KangaTech) in an elite male Australian Football League setting.

The Effect Of A Five-Week Hippotherapy Programme On Gait In A Child With Angelman's Syndrome. A Case Study Using The Wee Glasgow Gait Index (Weeggi)

Background/Aims Hippotherapy is a treatment modality performed by a qualified physical, occupational or speech therapist, using equine movement to gain therapeutic outcome; hippotherapy has been shown to improve gross motor development, tone, spasticity, balance, coordination, range of movement and muscle length. Angelman Syndrome is a rare genetic condition that causes ataxia, poor coordination and balance, reduced mobility, high tone and learning difficulties. Research into hippotherapy in Angelman Syndrome is sparse; therefore, this case study aimed to investigate the effect of a 5-week hippotherapy intervention on gait in a child with Angelman Syndrome, using the Wee Glasgow Gait Index (WeeGGI) Measure. Methods One participant was recruited to the case study using convenience sampling. The equine was selected based on their conformation, temperament and suitability for hippotherapy. A 5-week programme of hippotherapy was delivered using one equine, one therapist, a leader and two side walkers. Each session ranged between 30 and 40 minutes. A full physiotherapy assessment and the WeeGGI outcome measure were completed at pre and post-intervention. Results On the WeeGGI measure, a reduction of five points was achieved on the left leg and a reduction of two points was achieved for the right leg. Furthermore, an improvement in range of movement and muscle length was observed into left hip abduction, bilateral hamstrings and bilateral gastrocnemius and soleus. In addition to these results, the child was noted to have improved balance reactions, concentration, core strength and acceptance of base of support towards the end of the intervention period. Conclusions This 5-week hippotherapy programme demonstrated improvement in gait pattern, range of movement and muscle length in a child with Angelman Syndrome. Additionally, the child was noted to improve in non-gait specific domains, such as balance and independent adjustment of position while mounted. These findings add to the evidence base for the use of hippotherapy in rarer genetic conditions and suggest that hippotherapy is an effective and feasible treatment modality for this population. However, this was a small sample size and therefore it would be beneficial for further research to be carried out on a larger scale in order to generalise these findings to the wider population.

Validation of joint angle measurements: Comparison of a novel low cost marker-less system with an industry standard three-dimensional marker-based system

Human motion tracking is widely used for assessment of movement dysfunction in orthopaedic patients. Currently, most clinical motion analysis centres use marker based three-dimensional systems as they are deemed to be the most accurate method. However, due to space, costs and logistics they are not available in many clinical settings. This study compared joint angles measured in functional tests using the novel low-cost Microsoft Kinect Perfect-Phorm marker-less system with the established marker based Nexus VICON system. Ten unimpaired volunteers were fitted with 16 retroreflective markers in the positions specified by the Plug-in-Gait (PiG) lower limb marker set. Participants were asked to make three movements: standing, a squat action and a hip abduction action. The two measurement systems were used simultaneously to measure changes in joint angle. The collection of data from each participant was synchronised manually between each system. Average values for left and right knee flexion (for the squat task) and left hip abduction (for the hip abduction task) were obtained from each system as the average across the steady state, and the relative change between the standing and task sections used as the basis of comparisons of system performance. When measuring right and left knee flexion, the average difference between the VICON and Perfect-Phorm measurement was 13.2%, with a SD of 19.6. Both overestimation and underestimation of the joint angle was recorded in different participants. Although the average percentage difference during hip abduction tests was lower at −3.9%, the range of error was far greater (SD = 75). From this, it can be concluded that the level of accuracy presented in the new low cost Perfect-Phorm marker-less system is not yet suitable for clinical assessments. However, for general tests of performance, and for tracking cases where absolute accuracy is less critical, future versions of this software may have a place.

Relationship between physical performance and quality of life in Charcot-Marie-Tooth disease: a pilot study.

Charcot-Marie-Tooth (CMT) is a rare inherited peripheral neuropathy in which quality of life (QoL) is reduced compared with the general population. This paper investigates the relationship between QoL and physical performance in people with CMT with the aim of identifying avenues for future research into rehabilitation strategies. Cross-sectional data was obtained from 10 participants (5 men, 5 women, age 46 ± 13 years, height 1.7 ± 0.1 m, body mass 77 ± 17 kg) with CMT (CMT1A n = 5; CMT-X n = 3; unknown genetic origin n = 2). Participants were evaluated for QoL, falls efficacy (FES), balance, mobility, muscle strength, and power. Physical component score (PCS) of the Short Form-36 (SF-36) was significantly and directly related to higher leg press power (r = 0.75, p = 0.02). Better FES scores were significantly related to faster habitual gait speed (r = -0.70, p = 0.02), left hip abduction, and seated row strength (r = -0.68, p = 0.03; r = -0.73, p = 0.03, respectively). Future research should aim to substantiate these preliminary findings in a larger cohort and investigate whether interventions targeting muscle strength and power can improve QoL and mobility outcomes in people with CMT.

Asymmetry of lumbopelvic movement patterns during active hip abduction is a risk factor for low back pain development during standing

An induced-pain paradigm has been used in back-healthy people to understand risk factors for developing low back pain (LBP) during prolonged standing. We examined asymmetry of lumbopelvic movement timing during a clinical test of active hip abduction in back-healthy people who developed LBP symptoms during standing (Pain Developers; PDs) compared to back-healthy people who did not develop LBP symptoms during standing (Non Pain Developers, NPDs). Participants completed the hip abduction test while movement was recorded with a motion capture system. Difference in time between start of hip and lumbopelvic movement was calculated (startdiff). PDs moved the lumbopelvic region earlier during left hip abduction than right hip abduction. There was no difference between sides in NPDs. In PDs, the amount of asymmetry was related to average symptom intensity during standing. Asymmetric lumbopelvic movement patterns may be a risk factor for LBP development during prolonged standing.

Jump Test Performance and Sarcopenia Status in Men and Women, 55 to 75 Years of Age

Jumping mechanography uses maximal countermovement jumps to test obtain such as jump power (JPow). Recently, it has been shown to be a safe method for assessing muscle function in older adults; however, little is known about the relationships between JPow, muscle strength, and sarcopenia status. The purpose of this study was to examine jump performance, muscle strength, and sarcopenia status in older adults. This was a cross-sectional study that included men (n = 27) and women (n = 33) (55-75 years) recruited from the general community. Participants completed health status and physical activity questionnaires. Body composition, including appendicular skeletal muscle mass (ASM), bone free lean body mass, and relative skeletal muscle mass index, were assessed by total body dual-energy x-ray absorptiometry scans. The criteria for sarcopenia were relative skeletal muscle mass index values less than 7.26 kg/m2 for men and less than 5.45 kg/m2 for women. Three vertical jumps on a jump mat were performed to assess JPow, jump velocity (JVel), and jump height (JHt). Muscle strength was measured by 1RM testing for leg press (LP) and right and left hip abduction isotonic resistance exercises. Sarcopenia was found in 20% (12/60) of the participants. Jump power was significantly lower (P = .001) in the sarcopenia group than in the normal group, 651.1 (41.7) W versus 851.0 (27.4) W, respectively. Jump power and JHt were significantly (P < .01) positively correlated (r = 0.54-0.77) with ASM and bone free lean body mass. Significant (P < .01) positive correlations (r = 0.43-0.70) were also reported between jump test variables (JPow, JVel, JHt) and muscle strength (LP, right and left hip abduction). The jump test protocol was conducted safely with no injuries or balance issues. Our finding of lower JPow in sarcopenic individuals adds new information to the existing literature on age-related declines in muscle power. Community-dwelling individuals classified as sarcopenic had significantly lower JPow but not muscle strength compared with their counterparts with normal amounts of muscle mass. Jump test variables were positively correlated with lean tissue and lower body muscle strength. Based on our findings, JPow may be useful for sarcopenia screening in the middle-aged and older adults; however, more research is needed to determine the utility of this method in clinical populations.

PR_082: Isolated Superior Gluteal Nerve Injury After Blunt Trauma: A Case Report

Setting: Tertiary care hospital. Patient: A 52-year-old male patient with lateral hip pain and gait disturbance. Case Description: The patient developed left lateral hip pain and gait disturbance after a violent fall on the left buttock after being hit by a car. Radiologic studies showed no fracture and dislocation on the pelvis and left hip area. Manual muscle testing revealed F+ in left hip abduction and G in left hip internal rotation. When standing on his left leg, his trunk lurched to the left. The sensory exam was intact throughout. Reflexes were normal at the knees and ankles. Assessment/Results: Atrophic change of gluteus medius muscles was noted in magnetic resonance imaging and ultrasonography. Motor and sensory nerve conduction studies were normal in the left leg. Needle electromyography revealed 1+ positive sharp wave and fibrillation potentials and reduced interferential pattern in the left gluteus medius, gluteus minimus, and tensor fascia lata muscles. The gluteus maximus, iliopsoas, hip adductors, vastus medius, tibialis anterior, gastrocnemius, and paralumbar muscles were all normal. These findings suggested isolated injury of the left superior gluteal nerve. Discussion: Isolated lesions of superior gluteal nerve are rare and have been reported after misplaced needle injections, hip surgery and trauma, and hemorrhage into the gluteal compartment. Conclusions: We report a case of isolated superior gluteal nerve lesion following blunt trauma as confirmed by electrodiagnosis and MRI.

Electromyographic Analysis of Hip Rehabilitation Exercises in a Group of Healthy Subjects

Single-occasion, repeated-measures design. To determine the magnitude of hip abductor muscle activation during 6 rehabilitation exercises. Many researchers have reported that hip strengthening, especially of the hip abductors, is an important component of a lower extremity rehabilitation program. Clinicians employ non-weight-bearing and weight-bearing exercise to strengthen the hip musculature; however, researchers have not examined relative differences in muscle activation during commonly used exercises. Information regarding these differences may provide clinicians with a scientific rationale needed for exercise prescription. Sixteen healthy subjects (mean +/- SD age, 27 +/- 5 years; range, 18-42 years; mean +/- SD height, 1.7 +/- 0.2 m; mean +/- SD body mass, 76 +/- 15 kg) volunteered for this study. Bipolar surface electrodes were applied to the right gluteus medius muscle. We measured muscle activation as subjects performed 3 non-weight-bearing (sidelying right hip abduction and standing right hip abduction with the hip at 0 degrees and 20 degrees of flexion) and 3 weight-bearing (left-sided pelvic drop and weight-bearing left hip abduction with the hips at 0 degrees and 20 degrees of flexion) exercises. Data were expressed as a percent of maximum voluntary isometric contraction of the right gluteus medius. Differences in muscle activation across exercises were determined using a 1-way analysis of variance with repeated measures, followed by a sequentially rejective Bonferroni post hoc analysis to identify differences between exercises. The weight-bearing exercises demonstrated significantly greater EMG amplitudes (P<.001) than all non-weight-bearing exercises except non-weight-bearing sidelying hip abduction. The weight-bearing exercises and non-weight-bearing sidelying hip abduction exercise resulted in greater muscle activation because of the greater external torque applied to the hip abductor musculature. Although the non-weight-bearing standing hip abduction exercises required the least activation, they may benefit patients who cannot safely perform the weight-bearing or sidelying hip abduction exercises. Clinicians may use results from this study when designing hip rehabilitation programs.

The Relationship between Hip Muscle Strength and Golf Performance

0094 Hip muscles play an important role in balancing the forces transferred between the lower body and upper extremities during the golf swing. Stronger hip muscles may provide better trunk stability that may in turn be related to better golf performance. PURPOSE: To determine if there is any difference in hip strength among golfers with different proficiency levels and to determine the relationship between hip strength and golf handicap, and between hip strength and self-reported driving distance. METHODS: Eighty-two golfers who participated in the study were divided into three groups based on their proficiency level [handicap: 10–19 (group I, n = 23), 0–9 (group II, n = 47) and scratch or better (group III, n = 12)]. Isometric hip abduction and adduction strength in side-lying with the hip joint in neutral position were measured and normalized to body weight for both legs using a dynamometer. Selfreported golf driving distance and handicap were recorded. One-way ANOVAs were performed to compare group differences in hip muscle strength. In addition, Pearson product-moment correlation coefficients were calculated to determine if hip muscle strength is significantly related to golf handicap or driving distance. RESULTS: Left hip abduction strength was significantly different among groups (group III: 170.9 ± 38.0% > group II: 148.3 ± 33.9% > group I: 131.7 ± 41.2%BW, p = .013). No other hip strength variables were statistically significantly different among groups. Pearson product-moment correlation coefficients showed that left hip abduction strength has a mild relationship with both golf handicap (r = −.334, p = 0.02) and driving distance (r = −.320, p = .003). CONCLUSION: In addition to the statistically significant stronger left hip abduction strength in the better golfers, group III (scratch or better) also tended to be stronger in all hip movements that were tested. The results of this study demonstrate the importance of hip musculature for stability of the trunk and overall golf performance.