Passive Hip Research Articles

Age-Related and Side-Dependent Differences in Hip Range of Motion among Female Indian Athletes: Establishing Reference Values

Restricted hip mobility and flexibility are always associated with increased risk for lower extremity injury and poor athletic performance in female athletes. Reference values for hip motions in female athletes by age and sports are lacking. The primary aim of the study is to document the active and passive range of motion of hip joint among adolescent and adult Indian female athletes. Next, to compare between the sides and age group in the same population. This is a cross-sectional study involving 498 healthy female athletes of age group 15-21 years involved in the high impact sports were conveniently selected for the measurements of hip active and passive range of motion with a Universal goniometer. Participants with recent history of musculoskeletal injury and neurological pain syndromes were excluded from the study. Comparing the baseline values of active and passive range of motion of hip joint, between adolescent and adult female athletes, revealed a significant difference (p<0.05) in both dominant and non-dominant leg except for passive hip abduction (p>0.05). However, adolescents demonstrated higher hip flexion, internal rotation, and external rotation, and adults showed greater hip extension. Active and passive reference values for hip range of motion is documented for South Indian female athletes in relation to age and high impact sports. Future research involving injury prediction, prevention and rehabilitation protocol among female sports can utilize these values.

Acute effects of different administration order of stretching exercises: effects on range of motion and cross-over effect.

The aim of this manuscript is to investigate if stretching exercise administration order may influence outcomes pertinent to range of movement (ROM). A total sample of 108 participants was randomized into five groups. Eight sets of unilateral static stretching (SS) of 30s duration each with a 30s rest were administered to the right leg. One group underwent SS of the knee extensors (KE), another to the knee flexors (KF), another first to the KE and then to the KF, another first to the KF and then to the KE while the last group was used as control (CG). Each group was assessed for ROM of both lower limbs for either the KE and KF motion (passive hip extention [PHE] and passive straight leg raise [PSLR], respectively). Measures were assessed before (T0), immediately after (T1), and 15 minutes after the intervention (T2). No differences were observed for time (T0 vs. T1 vs. T2) for all measures in the CG for both limbs. Time-x-group interactions were observed only in the intervention limb (P<0.0007 and 0.004, ES 0.73 and 0.55, for KE and KF, respectively). Within the intervention limb, a significant increase in the PHE was observed from T0 to T1 only in the KE and KF/KE groups. For measures of the PSLR, a significant increase was observed from T0 to T1 only in the KF and KE/KF groups. No differences neither for time or group were observed in the control limb. Our results highlight that exercise administration order has an effect on ROM outcomes. Measures of ROM significantly increase only for the last stretched muscle in each intervention group. No crossover effect was observed in the contralateral limb.

Design and analysis of a passive exoskeleton with its hip joint energy-storage.

A novel passive hip exoskeleton has been designed and built with the aim of reducing metabolic consumption during walking by a passive way of storing the negative mechanical energy in the deceleration phase and releasing it in the acceleration phase. A ratchet spiral spring mechanism with a set of double stable switches is designed inside the exoskeleton for the above purpose. An analysis is conducted on the mechanism and the switching timing for the energy management to automatically store or release the energy according to the biomechanics of walking. In addition, a gravity-balance mechanism embedded inside the exoskeleton is designed as well to minimize the influence of the lower limb weight on muscle work. Human-exoskeleton interaction has been studied using the Opensim software, and simulation results demonstrated the effectiveness of the exoskeleton in reducing metabolic consumption during walking. An exoskeleton prototype has been built and tested with experiments measuring assistive torque and surface electromyography signal, confirming the effectiveness of the gravity-balance mechanism and energy-storage method, as well as the exoskeleton's actual assistive effect.

Can a passive unilateral hip exosuit diminish walking asymmetry? A randomized trial

BackgroundAsymmetric walking gait impairs activities of daily living in neurological patient populations, increases their fall risk, and leads to comorbidities. Accessible, long-term rehabilitation methods are needed to help neurological patients restore symmetrical walking patterns. This study aimed to determine if a passive unilateral hip exosuit can modify an induced asymmetric walking gait pattern. We hypothesized that a passive hip exosuit would diminish initial- and post-split-belt treadmill walking after-effects in healthy young adults.MethodsWe divided 15 healthy young adults evenly between three experimental groups that each completed a baseline trial, an adaptation period with different interventions for each group, and a post-adaptation trial. To isolate the contribution of the exosuit we compared a group adapting to the exosuit and split-belt treadmill (Exo-Sb) to groups adapting to exosuit-only (Exo-only) and split-belt only (Sb-only) conditions. The independent variables step length, stance time, and swing time symmetry were analyzed across five timepoints (baseline, early- and late adaptation, and early- and late post-adaptation) using a 3 × 5 mixed ANOVA.ResultsWe found significant interaction and time effects on step length, stance time and swing time symmetry. Sb-only produced increased step length asymmetry at early adaptation compared to baseline (p < 0.0001) and an after-effect with increased asymmetry at early post-adaptation compared to baseline (p < 0.0001). Exo-only increased step length asymmetry (in the opposite direction as Sb-only) at early adaptation compared to baseline (p = 0.0392) but did not influence the participants sufficiently to result in a post-effect. Exo-Sb produced similar changes in step length asymmetry in the same direction as Sb-only (p = 0.0014). However, in contrast to Sb-only there was no significant after-effect between early post-adaptation and baseline (p = 0.0885).ConclusionThe passive exosuit successfully diminished asymmetrical step length after-effects induced by the split-belt treadmill in Exo-Sb. These results support the passive exosuit’s ability to alter walking gait patterns.

The Gluteus Medius Experiences Significant Excursion With Hip Flexion

To evaluate the effect of hip flexion and rotation on excursion of the gluteus medius (Gmed) and minimus (Gmin) myotendinous unit. Seven hips from 4 cadaveric specimens (males, 68.5 ± 18.3 years old) were dissected to isolate the Gmed posterior and lateral insertions and the Gmin proximal and distal insertions. Sutures were placed from tendon insertions through origins created in the iliac fossa to simulate the myotendinous unit. A load of 10N was applied. Myotendinous excursion was measured at 10° hip extension and 0°, 45°, and 90° of hip flexion in neutral rotation, and from maximum internal and external rotation in 90° flexion. The amount of abduction and rotation was also measured at each flexion position with 20N applied to each tendon. Repeated-measures analysis of variance with Tukey post hoc was used for statistics. Gmed-lateral excursion ranged from 2.4 ± 0.4 mm in 10° of hip extension to 23.0 ± 1.5 mm in 90° of flexion (P < .001), and Gmed-posterior excursion ranged from 0.92 ± 0.5 mm in 10° of extension to 38.1 ± 1.1 mm in 90° of flexion (P < .001). Gmin excursion shortened with hip flexion from 4.2 ± 0.3 mm in 10° of extension to-0.2 ± 1.5 mm in 90° of flexion (Gmin-prox: P= .525, Gmin-distal: P < .001). At 90° flexion from maximum internal to maximum external rotation, Gmin-distal and proximal demonstrated a 92.6% and 51.3% increase in excursion, respectively (P < .001). Gmed-lateral and Gmed-posterior demonstrated 49.4% and 23.1% increase in excursion with external rotation, respectively (P < .001). The Gmed myotendinous unit undergoes significant excursion with hip flexion, whereas both Gmed and Gmin had significant excursion with femoral external rotation in 90° flexion. It is important to understand whether active or passive hip flexion or rotation in the early postoperative period causes excessive strain to an abductor tendon repair. We found that consideration should be given to limit flexion after Gmed repair and external rotation after Gmed or Gmin repairs.

Quantifying the shear modulus of the adductor longus muscle during hip joint motion using shear wave elastography

The present study aims to assess the effect of the hip flexion angle on the shear modulus of the adductor longus (AL) muscle associated with passive hip abduction and rotation. Sixteen men participated in the study. For the hip abduction task, the hip flexion angles used were − 20, 0, 20, 40, 60, and 80°, and the hip abduction angles were 0, 10, 20, 30, and 40°. For the hip rotation task, the hip flexion angles used were − 20, 0, 20, 40, 60, and 80°, hip abduction angles were 0 and 40°, and hip rotation angles were 20° internal rotation, 0° rotation, and 20° external rotation. The shear modulus at 20° extension was significantly higher than that at 80° flexion for the 10, 20, 30 and 40° hip abduction (i.e., P < 0.05). The shear modulus at 20° internal rotation and 20° extension was significantly higher than that at 0° rotation and 20° external rotation, regardless of the hip abduction angle (i.e., P < 0.05). The mechanical stress of the AL muscle associated with hip abduction was higher in the extended position. Furthermore, the mechanical stress could increase with internal rotation only at the hip-extended position.

Can Hip Passive Range of Motion Predict Hip Microinstability? A Comparative Study

Background: Hip microinstability is an increasingly recognized cause of pain and disability in young adults. It is unknown whether differences in passive hip range of motion (ROM) exist between patients with versus without hip microinstability. Hypothesis: Underlying ligamentous and capsular laxity will result in differences in clinically detectable passive ROM between patients with femoroacetabular impingement (FAI), patients with microinstability, and asymptomatic controls. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A retrospective review of all patients undergoing hip arthroscopy between 2012 and 2018 was conducted. Patients with a diagnosis of isolated microinstability based on intraoperative findings were identified and classified as having isolated FAI, instability, or FAI + instability. Patients without a history of hip injury were included as controls. Range of motion was recorded in the supine position for flexion, internal rotation, and external rotation. Univariate and multivariate analysis was performed on each measurement in isolation as well as combinations of motion to include total rotation arc, flexion + rotation arc, and flexion + 2× rotation arc Models were then created and tested to predict instability status. Results: In total, 263 hips were included: 69 with isolated instability, 50 with FAI, 50 with FAI + instability, and 94 control hips. A higher proportion of patients in the instability and FAI + instability groups were female compared with the FAI and control groups ( P &lt; .001). On univariate analysis, differences were found in all groups in all planes of motion ( P &lt; .001). Multivariable analysis demonstrated differences in all groups in flexion and flexion + rotation arc. In symptomatic patients, the best performing predictive model for hip microinstability was flexion + rotation arc ≥200° (Akaike information criterion, 132.3; P &lt; .001) with a sensitivity of 68.9%, specificity of 80.0%, positive predictive value of 89.1%, and negative predictive value of 51.9%. Conclusion: Patients with hip microinstability had significantly greater ROM than symptomatic and asymptomatic cohorts without hip microinstability. Symptomatic patients with hip flexion + rotation arc ≥200° were highly likely to have positive intraoperative findings for hip microinstability, whereas instability status was difficult to predict in patients with a flexion + rotation arc of &lt;200°.

Stability, performance and upper and lower extremities range of motion in elite beach handball athletes: A cross sectional study

Although beach handball is a popular sport worldwide, information about the functional profile in elite athletes are lacking. This study generate a descriptive profile of stability, performance and upper and lower extremities ROM in elite beach handball athletes. Secondary proposals were to compare these outcome measures between sexes and sides, and to report the frequency of athletes “at risk” according to cutoff values for shoulder ROM and dynamic postural stability of the lower extremities. Twenty-eight (n = 16 males, 28.7 ± 5.3 years; n = 12 females, 27.5 ± 5.5 years) elite beach handball athletes were tested. Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), single hop test, modified Star Excursion Balance Test (mSEBT) and passive shoulder, hip and ankle dorsiflexion ROM were assessed. Male athletes presented greater reach distance in the anterior direction [P < .0001; Mean Difference (MD): 36%] and lower reach distance in the posteromedial direction (P < .0001; MD: −29.7%) than female athletes in the mSEBT. Bilateral differences were observed for male athletes during the mSEBT, with the dominant stance limb obtaining a smaller reach distance in the anterior direction (P < .01; MD: −38.3%) and greater reach distance in the posteromedial direction (P < .0001; MD: 30.8%). Male athletes had less upper and lower extremities ROM and reached a smaller normalized single hop distance than female athletes. Most athletes presented mSEBT asymmetries and shoulder ROM deficits which have been shown to increase injury risk. Dynamic postural stability adaptations are present in elite beach handball athletes of both sexes, with more pronounced upper and lower extremity flexibility deficits in male athletes.

POLYETHYLENE LINER MOTION IN DUAL MOBILITY HIP PROSTHESES: STATIC AND DYNAMIC RADIOSTEREOMETRY IN 16 CASES ONE YEAR AFTER OPERATION

Dual mobility hip arthroplasty utilizes a freely rotating polyethylene liner to protect against dislocation. As liner motion has not been confirmed in vivo, we investigated the liner kinematics in vivo using dynamic radiostereometry.16 patients with Anatomical Dual Mobility acetabular components were included. Markers were implanted in the liners using a drill guide. Static RSA recordings and patient reported outcome measures were obtained at post-op and 1-year follow-up. Dynamic RSA recordings were obtained at 1-year follow-up during a passive hip movement: abduction/external rotation, adduction/internal rotation (modified FABER-FADIR), to end-range and at 45° hip flexion. Liner- and neck movements were described as anteversion, inclination and rotation.Liner movement during modified FABER-FADIR was detected in 12 of 16 patients. Median (range) absolute liner movements were: anteversion 10° (5–20), inclination 6° (2–12), and rotation 11° (5–48) relative to the cup. Median absolute changes in the resulting liner/neck angle (small articulation) was 28° (12–46) and liner/cup angle (larger articulation) was 6° (4–21). Static RSA showed changes in median (range) liner anteversion from 7° (-12–23) postoperatively to 10° (-3–16) at 1-year follow-up and inclination from 42 (35–66) postoperatively to 59 (46–80) at 1-year follow-up. Liner/neck contact was associated with high initial liner anteversion (p=0.01).The polyethylene liner moves over time. One year after surgery the liner can move with or without liner/neck contact. The majority of movement is in the smaller articulation between head and liner.

Predicting injury risk using machine learning in male youth soccer players

The aim of this study was twofold: a) to build models using machine learning techniques on data from an extensive screening battery to prospectively predict lower extremity soft tissue (LE-ST) injuries in non-elite male youth soccer players, and b) to compare models' performance scores (i.e., predictive accuracy) to select the best fit. A sample of 260 male youth soccer players from the academies of five different Spanish non-professional clubs completed the follow-up. Players were engaged in a pre-season assessment that covered several personal characteristics (e.g., anthropometric measures), psychological constructs (e.g., trait-anxiety), and physical fitness and neuromuscular measures (e.g., range of motion [ROM], landing kinematics). Afterwards, all LE-ST injuries were monitored over one competitive season. The predictive ability (i.e., area under the receiver operating characteristic curve [AUC] and F-score) of several screening models was analysed and compared to select the one with the highest scores. A total of 45 LE-ST injuries were recorded over the season. The best fit screening model developed (AUC = 0.700, F-score = 0.380) allowed to successfully identify one in two (True Positive rate = 53.7 %) and three in four (True Negative rate = 73.9 %) players at high or low risk of suffering a LE-ST injury throughout the in-season phase, respectively, using a subset of six field-based measures (knee medial displacement in the drop jump, asymmetry in the peak vertical ground reaction force during landing, body mass index, asymmetry in the frontal plane projection angle assessed through the tuck jump, asymmetry in the passive hip internal rotation ROM, and ankle dorsiflexion with the knee extended ROM). Given that these measures require little equipment to be recorded and can be employed quickly (approximately 5–10 min) and easily by trained staff in a single player, the model developed might be included in the injury management strategy for youth soccer.

Modified surgical anchor refixation in older patients with acute proximal hamstring rupture: clinical outcome, patient satisfaction and muscle strength

IntroductionAfter conventional surgical refixation of the hamstrings after proximal hamstring rupture, patients frequently experience pain while sitting and deficits in hamstring muscle strength of the operated side. To improve these outcomes, we have modified the surgical anchor placement and have carried out a thorough follow-up examination.Materials and methodsThirteen older patients (8 female, 5 males) with a median age of 64.2 (range, 52.1–80.4) years were surgically treated for acute proximal hamstring rupture using modified anchor placement and participated in a follow-up assessment at a median of 46.2 (11.2–75.0) months after surgery. Patients completed the Perth Hamstring Assessment Tool (PHAT), quality of life questionnaire (EQ-5D-5L) and the Lower Extremity Functional Scale (LEFS), and rated their satisfaction level on a scale from 0 to 100%. Local tenderness on the ischial tuberosity and maximum passive hip flexion were measured on both limbs. Maximum isokinetic knee flexor muscle strength was measured bilaterally using a dynamometer.ResultsThe median (range) PHAT, EQ-5D-5L and LEFS score were 78.8/100 (54.6–99.8), 0.94/1 (0.83–1) and 88.75/100 (61.25–100). The median satisfaction was 100% (90–100%). Only one patient felt discomfort when the ischial tuberosity was palpated. Neither maximum passive hip flexion nor maximum isokinetic flexor muscle strength differed between the operated and non-operated side (P > 0.58). Clinical scores did not correlate with the leg symmetry index of knee flexor muscle strength (Spearman’s rho < 0.448, P > 0.125). There were no tendon re-ruptures, or postoperative sciatic radiculopathy, at the time of follow-up.ConclusionsThe modified extra-anatomical anchor placement resulted in good clinical and functional outcome of surgical repair of acute proximal hamstring rupture. Especially the absence of postoperative pain while sitting and the comparable muscle strength to the contralateral side is promising.Clinical trial registrationClinicalTrials.gov Identifier: NCT04867746, registered.

Assessment of Hip Range of Motion Limitations in Cases with Low Back Pain Based on the Classified Movement System Impairment.

The hip joint's limitation causes lumbopelvic compensatory motions, accumulating tissue stress on the lumbar spines. It is essential and valuable to evaluate hip rotation range of motion (ROM) in different low back pain (LBP) classifications to understand them and plan the best exercise program. This study aimed to compare hip rotation ROM between subjects with and without LBP classified in movement system impairment (MSI). In this cross-sectional study, 100 subjects with LBP were classified into different MSI subgroups (mean age of 41.66 ± 7.82 years), and 100 healthy subjects (mean age of 38.96 ± 8.84 years) participated. Passive and active hip medial and lateral rotations ROM in prone and supine positions for dominant and non-dominant lower limbs were measured. Generally, in the LBP group, minimal lateral rotation as compared to controls in movement tests measuring hip rotation ROM actively and passively, in prone and sitting positions, and for dominant and non-dominant limbs (P < 0.05). There were no significant differences among the LBP subgroups (P > 0.05). Due to LBP, regardless of the MSI categories, remarkably restricted hip lateral rotation ROM.

Effects of different bed heights on the physical burden of physiotherapists during manual therapy: an experimental study.

This study aimed to determine the effect of physiotherapists' physical burden caused by different bed heights during manual therapy. Thirty-three male physiotherapists performed tasks simulating lumbar massage and passive hip abduction range-of-motion exercise (ROM) on the beds with low height (LH) and adjusted height (AH), with each task performed three times. The anterior inclination angle of the physiotherapist's trunk was measured, the surface electromyograms of the erector spinae and trapezius muscles were recorded, and perceived stress was assessed. The indexes obtained were statistically compared for different bed heights. Additionally, the lumbar disc compression force and flexion torque were estimated. The lumbar burden caused by the excessive bending and the biomechanical burden and perceived stress were stronger at LH than AH. In ROM tasks using the right hand, the muscle activity was lower at the left lumbar region at LH than at AH. At LH, the anterior inclination angle increased and the lumbar muscle activity declined as the number of tasks increased. The burden on the shoulders was not significantly different by bed heights. Our results showed that, when physiotherapists perform manual therapy, it is necessary to adjust the bed height to reduce physical burden and ensure higher quality of service.

Effect of the Sway Bed on Autonomic Response, Emotional Responses, and Muscle Hardness in Children with Severe Motor and Intellectual Disabilities: A Pilot Study.

This cross-sectional study aimed to examine the effects of being swayed in a sway bed on children with severe motor and intellectual difficulties by examining potential differences in their autonomic and emotional responses, as well as their muscle hardness, and by comparing them with "a control condition without any stimulation". Children's heart rate variability, rectus femoris hardness, and passive hip abduction range of motion (ROM) were measured in two experimental conditions, differentiated by the presence of a 5-min sway stimulus. In each condition, the children's faces were video-recorded and retrospectively rated subjectively by their homeroom teacher concerning the visible expression of eight emotions. Significant intervention-related effects were observed on the heart rate variability and the "Relax" item of the emotional response indicators but not on muscle hardness or hip ROM. Our findings provide evidence that using a motorized sway bed can promote relaxation in children with severe motor and intellectual disabilities by influencing their autonomic response.

Three-Dimensional Analysis Versus Two-Dimensional Slice-Based Analysis of CT for Measuring Femoral Torsion and Its Correlation to Passive Hip Range of Motion.

IntroductionFemoral torsion is an important anatomical consideration of the hip that has major implications on the natural motion of the hip joint. Similarly, it affects pathologic conditions of the hip, including femoroacetabular impingement, dysplasia, and/or microinstability. Femoral torsion is typically measured on two-dimensional (2D) axial CT cuts by creating the angle between the femoral neck and the posterior aspect of the ipsilateral femoral condyles. Position of the leg during imaging may affect 2D measurements. Three-dimensional (3D) analysis of a hip CT with inclusion of femoral alignment may portray the anatomy of the hip more accurately as compared to a 2D slice-based analysis of a hip CT scan. It is thought that femoral torsion measured using this system could be a more accurate and reliable means of measurement. The primary purpose of this study is to assess the differences in measuring femoral torsion with 3D modeling and analysis compared to the standard 2D slice-based approach on a CT scan. Secondarily, we attempt to determine how the passive range of motion of the hip correlates with femoral torsion measured using the 3D model versus the 2D model.MethodsIn a prospective cohort study of 20 patients, femoral torsion was assessed using both 2D analysis and 3D analysis. The differences between these measurements on each of the imaging modalities were compared. Additionally, each patient had the passive range of motion of their hip measured with a goniometer. The amount of internal and external rotation was measured with the hip in a neutral position and with the hip flexed to 90°. Acetabular version, combined version, and alpha angle were added to multivariate regression analysis to evaluate their effect versus femoral torsion alone.ResultsFemoral antetorsion measured using the standard 2D slice-based approach on CT scan was 22.1° (SD: 11.1°), which was higher (p<0.001) than that using 3D analysis (8.25°; SD: 10.5°). There was a strong correlation between femoral torsion measurements using 3D analysis and 2D analysis (R=0.91). Based on 3D analysis, there was a moderate correlation between femoral torsion and passive hip external rotation measured with the hip flexed to 90° (R=0.65, p<0.002) and with the hip in a neutral position (R=0.58, p<0.007).ConclusionThere was a significant difference between femoral torsion measurements using the 3D analysis, which showed approximately 14° of less antetorsion on average. Additionally, rotation of the hip and femoral torsion was correlated to higher levels of antetorsion associated with more internal rotation of the hip.

An Acute Hip Injury Correlated With An Exacerbation Of Urinary Symptoms In A Dancer

HISTORY23-year-old female dancer sustained an acute right hip/groin injury during a rond-de-jambe movement (requiring a combination of hip abduction, extension and external rotation). She had a sensation of a pop at the time of injury, followed by difficulty with external rotation as she attempted to continue to dance. Subsequent days were characterized by bruising to the inner groin and progressive medial thigh discomfort. She concurrently experienced a significant worsening of pre-existing urinary dysfunction characterized by episodes of urge incontinence and a sensation of incomplete voiding. She then developed secondary lateral hip, sacroiliac and low back discomfort. PHYSICAL EXAMShe presented to our office 6 weeks after the initial injury. She had a normal gait and symmetric hip range of motion. Right hip exam with pain at end range of passive hip flexion, and pain also with resisted testing of hip adduction, internal rotation and external rotation. She had tenderness over the anterior hip flexor tendons and at the proximal medial thigh just inferior to the pubic ramus. She was not tender to the pubic ramus. Thomas test was negative bilaterally, but she had significant tightness of quadriceps bilaterally noted on Ely’s test. An internal exam separately completed by her urogynecologist identified tightness of the pelvic floor musculature. DIFFERENTIAL DIAGNOSIS adductor muscle strain, strain of deep hip rotator muscles (obturator externus, obturator internus), hip flexor tendonitis (as primary or secondary diagnosis), labral tear, pelvic floor muscle strain/tear/dysfunction, primary or secondary tightness of pelvic floor musculature, hormonal and/or bladder irritants affecting urinary function TESTS AND RESULTS 1. Xray pelvis/hip series: Well-formed acetabula, slight predisposition to CAM type FAI 2. Hip MRI: Shallow right acetabulum with mild uncovering of lateral femoral head, signs of possible labral tear, small partial intramuscular tear of the R obturator externus, strain of R iliopsoas muscle 3. Dynamic hip ultrasound - pending FINAL WORKING DIAGNOSIS 1.Obturator externus strain with comorbid strain of iliopsoas muscle 2.Pelvic floor dysfunction TREATMENT AND OUTCOMES 1. Dance specific PT for core and peri-pelvic stabilization 2. Pelvic floor physical therapy 3. Gradual return to dance

Gender difference in effects of proprioceptive neuromuscular facilitation stretching on flexibility and stiffness of hamstring muscle.

Objective: This study investigated the acute effects of PNF stretching on hamstring flexibility and muscle stiffness of lower limbs between genders. Methods: 15 male and 15 female university students without any injury histories on lower limbs in the past 3 months were included in this study were selected. All subjects were measured by MyotonPRO before and after stretching to determine the muscle stiffness of the biceps femoris muscle (BF), semitendinosus muscle (ST) of the hamstring and the medial gastrocnemius muscles (MG), lateral gastrocnemius muscles (LG), and the soleus (SOL) of the triceps surae muscles. Additionally, their flexibility was measured using the sit-and-reach test (the SR test) and passive hip range of motion (ROM). Differences based on time (pre-stretching vs. post-stretching) and sex (females vs. males) were assessed using 2 × 2 repeated measures AVONA. Results: There was a significant decrease in the stiffness of the hamstring and triceps surae muscles after stretching (BF, MG, LG, and SOL: p < 0.001; ST: p = 0.003). The muscle stiffness of the hamstring and triceps surae muscles is larger in males than in females at all time points (p < 0.001). There was a significant increase in hip flexion angle and the SR test in males and females after PNF stretching (p < 0.001); However, there was no difference in the change in the muscle stiffness and the flexibility between genders (p > 0.05). Conclusion: PNF stretching helped improve hamstring flexibility and decrease muscle stiffness. Stretching the hamstrings can also contribute to a decrease in the stiffness of the triceps surae muscles. The muscle stiffness of males before and after stretching is always greater than that of females. However, there was no difference in the change of improvement in stretching between genders.

Parameters Affecting Worst-Case Gradient-Field Heating of Passive Conductive Implants.

Testing MRI gradient-induced heating of implanted medical devices is required by regulatory organizations and others. A gradient heating test of the ISO 10974 Technical Specification (TS) for active implants was adopted for this study of passive hip implants. All but one previous study of hip implants used nonuniform gradient exposure fields in clinical scanners and reported heating of less than 5 °C. This present study adapted methods of the TS, addressing the unmet need for identifying worst-case heating via exposures to uniform gradient fields. To identify gradient-field parameters affecting maximum heating in vitro for a hip implant and a cylindrical titanium disk. Computational simulations and experimental validation of induced heating. Tissue-simulating gel. 42 T/s RMS, sinusoidal, continuous B fields with high spatial uniformity ASSESSMENT: Hip implant heating at 1-10 kHz, via computational modeling, validated by limited point measurements. Experimental measurements of exposures of an implant at 42 T/s for 4, 6, and 9kHz, analyzed at 50, 100, and 150seconds. One sample student's t-test to assess difference between computational and experimental results. Experimental vs. computational results were not significantly different (p &lt; 0.05). Maximum simulated temperature rise (10-minute exposure) was 10 °C at 1kHz and 0.66 °C at 10 kHz. The ratio of the rise for 21 T/s vs. 42 T/s RMS was 4, after stabilizing at 50seconds (dB/dt ratio squared). Heating of an implant is proportional to the frequency of the B field and the implant's cross-sectional area and is greater for a thickness on the order of its skin depth. Testing with lower values of dB/dt RMS with lower cost amplifiers enables prediction of heating at higher values for dB/dt squared (per ISO TS) with identical frequency components and waveforms, once thermal equilibrium occurs. 1 TECHNICAL EFFICACY: Stage 1.

¿Es el estiramiento pasivo del cuádriceps igual de efectivo que el autoestiramiento en jugadores de fútbol? Ensayo clínico aleatorizado

ObjectiveTo compare the effects of quadriceps passive stretching or quadriceps self-stretching in muscle flexibility and hip range of motion (ROM) in football athletes. MethodsA randomized clinical trial was carried out. Thirty-four football athletes with lack of flexibility in the quadriceps muscle were included and randomized in two groups (Stretching group or self-stretching group) and received a single session of quadriceps passive stretching or quadriceps self-stretching in the dominant lower limb. The outcome variables were: quadriceps flexibility measured with the Ely's test, hamstring flexibility measured with the Passive Knee Extension test and hip flexion and extension ROM. ResultsBoth groups achieved a statistically significant improvement of quadriceps flexibility, hamstrings flexibility and hip extension ROM without statistically significant differences between them (p>0.05). The stretching group reported large effect sizes in muscle flexibility and hip extension ROM (d>0.8), and the effect sizes of the stretching group were higher than the self-stretching group. ConclusionsFlexibility of the quadriceps and hamstring muscles as well as hip extension ROM increased after stretching and self-stretching of the quadriceps muscle. The effect sizes shown by the stretching group were higher than those of the self-stretching group.

Examining the effects of femoral anteversion and passive hip rotation on ACL injury and knee biomechanics: a systematic review and meta-analysis.

PurposeGreater femoral internal rotation (via anteversion or passive hip ROM) is associated with knee biomechanics thought to contribute to anterior cruciate ligament (ACL) injury, but it is unknown if femoral internal rotation contributes to actual ACL injury occurrence. The objective of this systematic review and meta-analysis was to quantify the extent to which femoral anteversion and hip range of motion (ROM) influence knee biomechanics consistent with ACL injury and actual ACL injury occurrence.MethodsUsing PRISMA guidelines, PubMed, CINAHL, SportDiscus, and Scopus databases were searched. Inclusion criteria were available passive hip ROM or femoral anteversion measure, ACL injury OR biomechanical analysis of functional task. Two reviewers independently reviewed titles, abstracts, and full texts when warranted. Included studies were submitted to Downs & Black Quality Assessment Tool. Meta-analyses were conducted for comparisons including at least two studies.ResultsTwenty-three studies were included (11 injury outcome, 12 biomechanical outcome). Decreased internal rotation ROM was significantly associated with history of ACL injury (MD -5.02°; 95% CI [-8.77°—-1.27°]; p = 0.01; n = 10). There was no significant effect between passive external rotation and ACL injury (MD -2.62°; 95% CI [-5.66°—- 0.41°]; p = 0.09; n = 9) Participants displaying greater frontal plane knee projection angle had greater passive external rotation (MD 4.77°; 95% CI [1.17° – 8.37°]; p = 0.01; n = 3). There was no significant effect between femoral anteversion and ACL injury (MD -0.46°; 95% CI [-2.23°—1.31°]; p = 0.61; n = 2). No within-sex differences were observed between injured and uninjured males and females (p range = 0.09 – 0.63).ConclusionThough individuals with injured ACLs have statistically less passive internal and external rotation, the observed heterogeneity precludes generalizability. There is no evidence that femoral anteversion influences biomechanics or ACL injury. Well-designed studies using reliable methods are needed to investigate biomechanical patterns associated with more extreme ROM values within each sex, and their prospective associations with ACL injury.Level of evidence: IV.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40634-022-00479-7.