Pelvic Tilt Research Articles

Comparison of gait deviation index (GDI) and gait variability index (GVI) measured by marker-based and markerless motion capture systems in children with cerebral palsy (CP)

BackgroundThe Gait Deviation Index (GDI) is a metric clinicians use to assess overall gait pathology in children with cerebral palsy (CP) by comparing kinematic data to a normative sample. The Gait Variability Index (GVI) is a related metric that quantifies the variability in spatio-temporal variables during gait. The GDI and GVI have been verified using marker-based motion capture approaches, but video-based markerless motion capture has not been compared using these tools in children with CP. Research questionDo GDI and GVI scores differ when measured using markerlessTheia3D and a marker-based approach between the more and less affected legs in children with CP? MethodsFifteen children with CP (GMFCS levels I-IV) and 24 typically developing children aged 6–18 years were recruited for this study. Overground walking was performed at a self-selected pace while the pelvis and lower limb kinematics were simultaneously recorded using both motion capture systems. Differences in GDI and GVI scores when considering the effect of system and limb impairment were analyzed using two-way repeated-measures ANOVAs. ResultsGDI scores were 6.9 points lower (p < 0.05) when measured using Theia3D compared to the marker-based approach and 6.8 points lower (p < 0.05) in the more affected limbs than in the less affected limbs. These GDI score differences are considered clinically significant. No differences were identified in GVI scores between systems or limb impairment. Differences in kinematic measurements were found in children with CP, including pelvic tilt, hip flexion/extension, hip rotation, and foot progression angle, where root mean square differences between systems exceeded 10°. SignificanceTheia3D can adequately measure variability in spatio-temporal gait parameters for quantifying GVI scores in children with CP compared to the marker-based approach. However, caution is needed when quantifying lower limb kinematics and interpreting GDI and GVI scores using Theia3D in children with CP.

Comparison of two different stretching strategies to improve hip extension mobility in healthy and active adults: a crossover clinical trial

ObjectiveTo improve hip flexor flexibility, the commonly used hip extension stretch focuses on advancing the pelvis forward in a half-kneeling position, targeting only hip extension. This study aimed to compare the effectiveness of this traditional stretch with a new technique incorporating posterior pelvic tilt.MethodsA randomized crossover clinical trial was conducted with in 26 healthy, physically active individuals (52 hips), aged 22.50 ± 4.10 years. Each participant performed both the hip extension stretch and the posterior pelvic tilt stretch (26 hips), with one technique applied to each limb: the posterior pelvic tilt stretch on one limb and the hip extension stretch on the other limb (26 hips). The reactive hip flexor test and active knee extension test were measured pre and post stretching techniques. A repeated measures ANOVA was performed to assess differences between groups.ResultsThere was a significant group-by-time interaction with a medium effect size for the variable related to reactive hip flexor force (F = 4.775, p = 0.034, η2p = 0.087). The posterior pelvic tilt stretch had a statistically significant mean difference of 4.85 N·m (p = 0.003; 95%CI: 1.74; 7.96) compared with the hip extension stretch (mean difference = 0.06 N·m (p = 0.969; 95%CI-3.05; 3.17). No significant differences were found for active knee extension (p > 0.05).ConclusionsThe results showed that the posterior pelvic tilt stretching technique was effective in reducing the hip reactive flexor force when compared to conventional hip extension stretch.

Anterior Pelvic Tilt in MRI VS X-Rays. Which is more Sensitive?

The assessment of anterior pelvic tilt (APT) is crucial in diagnosing and treating various musculoskeletal disorders. This paper evaluates the sensitivity of measuring APT using magnetic resonance imaging (MRI) and X-ray techniques. By comparing the two modalities, we aim to determine the advantages and limitations of each in clinical practice. Our findings suggest that MRI offers greater sensitivity in measuring APT, providing valuable insights for clinicians in selecting the appropriate imaging modality.

Pelvic tilt and stiffness of the muscles stabilising the lumbo-pelvic-hip (LPH) complex in tensiomyography examination.

The objective of the study was to initially validate the hypothesis about the relationship between the pelvic tilt angle in the saggital plane and the functional state of muscles stabilising the lumbo-pelvic-hip (LPH) complex expressed as a change in their stiffness in a tensiomyography examination. Forty five women aged 19-30 years took part in an observational (cross-sectional) study. The examination involved measurements using the tensiomyography method (TMG). The stiffness of muscles stabilising the LPH complex expressed as a maximal muscle displacement (Dm variable) was assessed and the relationship between muscle stiffness and the value of the pelvic tilt (PT) in the sagittal plane was determined. The analysis showed significant differences in the values of medians of the muscle displacement (Dm) values in groups identified in terms of the value of pelvic tilt (Table 1) for Erector Spinae (ES) muscles (p = 0.0012), Gluteus Maximus (GM) muscles (p = 0.0004), Rectus Abdominis (RA) muscles (p = 0.0005), Obliquus abdominis externus (OAE) muscles (p = 0.0002*) and Rectus Femoris (RF) muscles (p = 0.0071). The results of the correlation analysis performed using the Spearman rho correlation coefficient between the value of pelvic tilt and muscle stiffness (Dm) show the following significant relations for ES muscles (p = 0<0.0001), GM muscles (p<0.0001), RA muscles (p<0.0001) and OAE muscles (p<0.0001). However, a clear direction of changes in stiffness in accordance with the description of relations defined as Lower Crossed Syndrome was not confirmed. A tensiomyographic examination did not show clear relations between the value of pelvic tilt and stiffness of muscles stabilising the lumbar-pelvic-hip complex. The mechanism of Lower Crossed Syndrome (LCS) may be not the only model explaining the relations between musculofascial structures of the hip-lumbar area. The implications of the LCS should not be the only basis for the therapy of disorders resulting from an incorrect position of the pelvis in the sagittal plane.

Anatomical landmark detection on bi-planar radiographs for predicting spinopelvic parameters.

Accurate landmark detection is essential for precise analysis of anatomical structures, supporting diagnosis, treatment planning, and monitoring in patients with spinal deformities. Conventional methods rely on laborious landmark identification by medical experts, which motivates automation. The proposed deep learning pipeline processes bi-planar radiographs to determine spinopelvic parameters and Cobb angles without manual supervision. The dataset used for training and evaluation consisted of 555 bi-planar radiographs from un-instrumented patients, which were manually annotated by medical professionals. The pipeline performed a pre-processing step to determine regions of interest, including the cervical spine, thoracolumbar spine, sacrum, and pelvis. For each ROI, a segmentation network was trained to identify vertebral bodies and pelvic landmarks. The U-Net architecture was trained on 455 bi-planar radiographs using binary cross-entropy loss. The post-processing algorithm determined spinal alignment and angular parameters based on the segmentation output. We evaluated the pipeline on a test set of 100 previously unseen bi-planar radiographs, using the mean absolute difference between annotated and predicted landmarks as the performance metric. The spinopelvic parameter predictions of the pipeline were compared to the measurements of two experienced medical professionals using intraclass correlation coefficient(ICC) and mean absolute deviation (MAD). The pipeline was able to successfully predict the Cobb angles in 61% of all test cases and achieved mean absolute differences of 3.3° (3.6°) and averaged ICC of 0.88. For thoracic kyphosis, lumbar lordosis, sagittal vertical axis, sacral slope, pelvic tilt, and pelvic incidence, the pipeline produced reasonable outputs in 69%, 58%, 86%, 85%, 84%, and 84% of the cases. The MAD was 5.6° (7.8°), 4.7° (4.3°), 2.8mm (3.0mm), 4.5° (7.2°), 1.8° (1.8°), and 5.3° (7.7°), while the ICC was measured at 0.69, 0.82, 0.99, 0.61, 0.96, and 0.70, respectively. Despite limitations in patients with severe pathologies and high BMI, the pipeline automatically predicted coronal and sagittal spinopelvic parameters, which has the potential to simplify clinical routines and large-scale retrospective data analysis.

Clinical benchmark dataset for AI accuracy analysis: quantifying radiographic annotation of pelvic tilt

Radiographic landmark annotation determines patients’ anatomical parameters and influences diagnoses. However, challenges arise from ambiguous region-based definitions, human error, and image quality variations, potentially compromising patient care. Additionally, AI landmark localization often presents its predictions in a probability-based heatmap format, which lacks a corresponding clinical standard for accuracy validation. This Data Descriptor presents a clinical benchmark dataset for pelvic tilt landmarks, gathered through a probabilistic approach to measure annotation accuracy within clinical environments. A retrospective analysis of 115 pelvic sagittal radiographs was conducted for annotating pelvic tilt parameters by five annotators, revealing landmark cloud sizes of 6.04 mm-17.90 mm at a 95% dataset threshold, corresponding to 9.51°–16.55° maximum angular disagreement in clinical settings. The outcome provides a quantified point cloud dataset for each landmark corresponding to different probabilities, which enables assessment of directional annotation distribution and parameter-wise impact, providing clinical benchmarks. The data is readily reusable for AI studies analyzing the same landmarks, and the method can be easily replicated for establishing clinical accuracy benchmarks of other landmarks.

Reduction of high-grade spondylolisthesis using minimally invasive spine surgery-transforaminal lumbar interbody fusion "trial-in-situ" technique: a technical note with case series.

This retrospective case series evaluated the effectiveness of minimally invasive spine surgery-transforaminal lumbar interbody fusion (MIS-TLIF) using the "trial-in-situ " technique for reducing high-grade spondylolisthesis. The surgical management of grade ≥III spondylolisthesis has been controversial, with various methods documented in the literature, including in-situ fusion, in-situ trans-sacral delta fixation, distraction techniques, and external reduction techniques. Recently, MIS techniques have gained popularity. This study analyzed 18 cases of high-grade spondylolisthesis treated with MIS-TLIF using the "trial-in-situ " technique. The clinical outcomes were assessed using the Visual Analog Scale (VAS) and the modified Oswestry Disability Index (mODI) scores. The spinopelvic parameters and sagittal balance were also analyzed. Preoperatively, the spinopelvic parameters were deranged, with a mean pelvic tilt of 28.31°, which improved to 13.91° postoperatively. Similarly, the sacral slope improved from 45.65° to 38.01°. VAS and mODI scores improved postoperatively, indicating the effectiveness of the "trial-in-situ " technique in reducing high-grade spondylolisthesis and achieving a better sagittal profile and spinopelvic parameters. The findings indicate that MIS-TLIF using the "trial-in-situ " technique is a viable and effective method for treating high-grade spondylolisthesis.

The Influence of Pelvic Tilt and Femoral Torsion on Hip Biomechanics: Implications for Clinical Assessment and Treatment

Background: Hip biomechanics are crucial in understanding movement disorders and joint pathologies. Pelvic tilt and femoral torsion are key factors influencing hip function and stability. This review aims to elucidate their effects on acetabular orientation, hip range of motion (ROM), and associated compensatory mechanisms. Methods: A comprehensive search of databases, including PubMed, Scopus, and Pedro, was conducted. Studies were selected based on Population, Concept, and Context (PCC) criteria, focusing on those examining the relationship between pelvic tilt, femoral torsion, and hip biomechanics. Eight studies were included, utilizing methodologies such as CT imaging, musculoskeletal modeling, and gait analysis, covering populations ranging from asymptomatic adults to elderly women with pelvic retroversion. Results: The review identified significant effects of pelvic retroversion on acetabular anteversion and hip extension. Some studies found no correlation between pelvic index (PI) and acetabular orientation, while others reported a linear increase in acetabular anteversion with pelvic retroversion. Subjects with pelvic retroversion showed greater hip extension. Additionally, femoral anteversion was linked to increased internal rotation and altered hip joint contact forces during gait, with changes in hip ROM and force distribution. No relationship was found between femoral and acetabular anteversion in patients with hip osteoarthritis. Conclusions: Pelvic tilt and femoral torsion significantly affect hip biomechanics, influencing acetabular orientation, ROM, and compensatory mechanisms. Future studies should include symptomatic populations to explore these relationships further. These findings emphasize the critical need for individualized clinical assessments and further research on symptomatic populations to enhance our understanding of pelvic tilt and femoral torsion’s impact on hip biomechanics.

Does Restoration of Lumbar and Segmental Cobb Angle Affect Fusion Outcome in Short-segment Posterior Lumbar Fusion?

To study the effect of lumbar lordosis change and pelvic parameters on surgical outcomes such as fusion vs. non-fusion (pseudarthrosis), Adjacent Segment Pathology (ASP), and re-operation in patients undergoing 1-, 2- and 3-level PLF. Adult patients with degenerative spine pathologies who had undergone PLF between L2 and L5 levels at an academic center between 2010 and 2020 were included. Pre-operative and early post-operative lateral standing X-Rays of the lumbar spine were used to measure pre-operative lumbar Cobb angle, Postoperative lumbar Cobb angle, pre-operative segmental Cobb angle (measured from the superior endplate of the upper instrumented vertebra to the inferior endplate of the lower instrumented vertebra), postoperative segmental Cobb angle, preoperative pelvic incidence (PI) and pelvic tilt (PT). Change in lumbar and segmental Cobb was calculated as postoperative Cobb angle (lumbar and segmental) minus preoperative Cobb angle. A total of 243 patients met our inclusion and exclusion criterion. Patients who had pseudarthrosis had a significantly less restoration of lumbar lordosis compared to those who did not, both for lumbar cobb angle change (-5.2±8.2 vs. -0.2±8.2; p=0.01) and segmental cobb angle change (-5.4±6.6 vs. -1.5±6.0; p=0.01). Moreover, PI was lower in patients who developed ASP vs. those who didn't. There was no significant difference in these measures (lumbar cobb angle changes and segmental cobb angle change) in patients who experienced ASP and those who did not. Better restoration of lumbar lordosis reduces rates of pseudarthrosis after short-segment PLF but has no association with rates of ASP.

Effect of Programed Walking Exercise Using Bot Fit in Younger Adults

IntroductionPhysical inactivity and sedentary behavior both increase the risk of chronic disease and mortality. Regular participation in physical activity and reducing sedentary behavior play important roles in maintaining physical health and disease prevention.ObjectiveThe purpose of this study was to investigate the effect of programed walking exercise using a wearable hip exoskeleton, Bot Fit on muscle strength, muscle effort, and the kinematics of the pelvis in younger adults.MethodsWe designed three parallel experimental conditions and randomly assigned participants to one of three groups: those assigned to exercise using an interval program of Bot Fit (interval group), those who used a power program of Bot Fit (power group), and a control group who exercised without Bot Fit. A total of 45 young adults participated in 18 exercise-intervention sessions over six weeks, and all participants were assessed at two time points: before and after the 18 exercise sessions. Each assessment evaluated muscle strength, muscle effort, and the kinematics of the pelvis during walking. In addition, the number of steps, distance, energy expenditure, and heart rate for 30 min during the exercise sessions were recorded.ResultsA significant increase in the maximum voluntary contraction (MVC) of the left biceps femoris (BF) was evident in the interval group, while significant changes in the MVC of the bilateral BF were seen in the power group after Bot Fit exercise. A significant decrease of muscle effort in the right BF in the interval group and right lumbar erector spinae and bilateral BF in the power group were also observed. In addition, the symmetry index of pelvic tilt significantly improved in the interval group, and greater exercise volume and intensity in both the interval and power groups compared with the control group were confirmed as measured by the number of steps, distance, energy expenditure, and heart rate.ConclusionsThe results of this study confirmed the beneficial effect of programed walking exercise using the Bot Fit on muscle strength of trunk and lower extremities, muscle effort, and pelvic movement symmetry in younger adults. Personalized exercise programs can be provided for younger adults using various resistance or assistance modes of robotic device with the Bot Fit.Trial RegistrationClinicalTrials.gov, NCT05862077. Registered 22 March 2022, https://register.clinicaltrials.gov/.

Factors associated with rod fracture following surgery for adult spinal deformity: a single-center retrospective study.

Adult spinal deformity (ASD) has a significant impact on trunk balance and quality of life in the elderly. Postoperative rod fractures pose significant challenges, but the mechanisms of their occurrence are underexplored compared to other complications such as proximal junctional kyphosis. This study investigated factors associated with rod fracture in patients with ASD. A retrospective single-center study analyzed 110 adult patients who underwent spinal deformity correction between 2012 and 2020. Comparative analysis and univariate and multivariate Cox regression analyses were employed to identify factors associated with rod fracture. In this study, rod fracture occurred in 14.5% of patients. The rod fracture group exhibited a larger change in lumbar lordosis (LL), a higher proportion of patients with pre-operatively existing (pre-existing) vertebral fractures, and a greater percentage of patients with a rod diameter of 6mm or less compared to the non-rod fracture group. Univariate Cox regression analysis revealed that rod fracture was associated with pre-existing vertebral fracture, LL change, preoperative sagittal vertical axis, and preoperative pelvic tilt. Multivariate Cox regression analysis identified pre-existing vertebral fractures and the amount of LL change as independent factors associated with rod fractures. Pre-existing vertebral fractures and the magnitude of lumbar lordosis correction are independent risk factors for rod fracture following ASD surgery. Surgeons should consider these factors during preoperative planning to reduce the risk of postoperative rod fracture. IV.

The Impact of Anterior Pelvic Tilt on Return to Duty/Return to Run in Active Duty Personnel After Hip Arthroscopy for Femoroacetabular Impingement.

Annually, 300,000 soldiers are rendered medically nondeployable because of musculoskeletal injuries (MSKIs). Of this population, nearly 10,000 (3.3%) involve injuries to the hip. Factors related to these injuries impose significant healthcare, financial, and readiness burdens on the Army system, degrading overall mission readiness. The purpose of this retrospective study was to assess for correlation between increased anterior pelvic tilt and a lower likelihood for return to duty/return to run (RTD/RTR) in active duty personnel who underwent hip arthroscopy for femoroacetabular impingement (FAI), thus identifying increased anterior pelvic tilt as a potential prognostic indicator for RTD/RTR. Ninety-two active duty U.S. Army service members aged 18 years or older who underwent hip arthroscopy for FAI at the William Beaumont Army Medical Center from September 1, 2014, to September 1, 2019, were included. Utilizing a retrospective review of existing data, the amount of anterior pelvic tilt, as estimated on a presurgical weight-bearing anterior-posterior pelvis radiograph using the distance from the pubic symphysis to the transischial line, was measured and compared to postoperative RTD/RTR statuses, assessing for correlation. The overall RTD rate was 39.1% with a 22.8% RTR rate. Only 6.5% (6/92) of subjects returned to full, unrestricted duty and running. Logistic regression analyses showed that individuals with increased anterior pelvic tilt (≥7°) were 2.6 times less likely to RTD and 2.9 times less likely to RTR compared to those with minimal or no anterior pelvic tilt (<7°) (respectively, odds ratio (OR) 2.619; 95% CI, 1.107-6.195; P = .029 and OR 2.897; 95% CI, 1.041-8.059; P = .042). Results support the study teams' hypothesis that increased anterior pelvic tilt is associated with a lower odds of RTD/RTR. Statistical analysis confirmed the correlation between an increased amount of anterior pelvic tilt and a lower odds of RTD and RTR after hip arthroscopy for FAI in active duty U.S. Army personnel. This information can be used in patient counseling to better inform shared decision-making, provide more thorough informed consent, and help determine the optimal timing for surgical intervention, thus contributing to better stewardship of medical resources and decreasing the ever-growing financial healthcare burden. These findings will spur future research to consider the causes and optimal treatment of anterior pelvic tilt, positively impacting the culture of Army medicine by focusing on preventive and targeted treatments in order to preserve and grow the force.

Clinical Implications of Surgical Resection without Spinal Fixation in Lumbar Dumbbell Tumors: Evaluating Postoperative Lumbar Alignment and Patient Outcomes

This study examined radiographic changes in local and global spinal alignments and clinical outcomes following tumor resection without spinal fixation in patients with lumbar dumbbell tumors (LDTs). We included 28 patients with LDTs who were followed for at least two years after surgery. We analyzed variations in the outcome variables by measuring individual coronal and sagittal parameters from radiographs. Clinical outcomes were assessed using the modified McCormick scale (MMCS), the Japanese Orthopaedic Association (JOA) score, and the visual analog scale (VAS). To evaluate the impact of tumor location on these outcomes, we categorized the patients into three groups based on tumor location: Upper (T12-L1), Middle (L2-3), or Lower (L4-S1) group. The local and global spinal parameters (including Cobb angle, cervical lordosis, T1 slope, thoracic kyphosis, thoracolumbar kyphosis, lumbar lordosis [global, upper, middle, lower], sacral slope, pelvic incidence, pelvic tilt) did not show significant changes after surgery. Preoperatively, all patients experienced gait disturbances, but at the final follow-up, nearly all of them (27 cases, 96.4%) could walk without support. The JOA score and VAS demonstrated significant postoperative improvements. There were no statistically significant group differences in postoperative coronal and sagittal profiles or clinical outcomes among the upper, middle, and lower groups. Tumor resection without spinal fixation had no substantial impact on local and global spinal alignments and led to satisfactory clinical outcomes, suggesting that spinal fixation may not always be necessary when resecting LDTs.

Waveform Analysis To Identify Biomechanical Relationships and Differences Between Softball Pitchers With and Without Pain.

Softball pitchers accrue high rates of injury. Research suggests certain mechanics at discrete pitch events are related with pain. Here, we examine relationships between peak throwing shoulder kinetics and trunk/pelvis kinematics and compare trunk/pelvis kinematics between pitchers who were healthy and those currently experiencing pain. (1) Peak shoulder kinetics would be positively related to greater trunk and pelvis flexion, lateral flexion, and rotation; and (2) pitchers in pain would exhibit greater trunk and pelvis flexion, lateral flexion, and rotation during the pitch than those who were pain-free. Cross-sectional study. A total of 42 high school pitchers (height, 1.71 ± 0.06 m; weight, 75.0 ± 15.9 kg; age, 16 ± 2 years) were separated into 2 groups based on presence or absence of pain. Peak kinetic data from 3 pitches per pitcher were averaged and used as dependent variables. Kinematic data were averaged across 3 trials, and time normalized to 101 datapoints between foot contact and follow-through of the pitch. Statistical parametric mapping regressions were used to assess the relationships between peak shoulder kinetics and waveform of trunk and pelvis kinematics. Pelvic lateral tilt significantly predicted peak throwing shoulder superior (P = 0.05) and lateral (P = 0.04) force. Pelvis rotation predicted peak superior force (P = 0.02). Waveform analyses revealed no waveform differences between healthy pitchers and those currently experiencing pain. Peak shoulder kinetic variables are related with pelvic positioning during the pitch; however, trunk and pelvis kinematics do not differ according to presence of pain. Pitchers in pain do not adopt specific trunk and pelvic alterations during the pitch, potentially concealing the effects of pain from visual identification. Coaches and clinicians need to discuss health status with pitchers versus relying on visual observations to understand pain and injury risk.

Course and Predictors of Adult Spinal Sagittal Disorders: A 10-year Prospective Case Series.

Prospective case series. To study the natural course of adult spinal deformity (ASD) over a10-year period and the determinants associated with postural malalignments. ASD comprises a heterogeneous spectrum of abnormalities of the thoracolumbar spine throughout adulthood. Radiographic deterioration of sagittal alignment is a combination of decreased lumbar lordosis (LL), PI-related retroversion of the pelvic tilt (PT), anteriorizing sagittal vertical axis (SVA) and increased T1 pelvic angle (TPA). The full spine radiographs were taken to measure the SRS-Schwab sagittal modifiers PI-LL, PT and SVA to measure the possible change in severity of deformity from the 204 volunteer participants (mean age 62.7 years, 61% female), which were 32% of the 637 consecutive patients with prolonged back pain who originally joined the study in 2012-2013. Each participant completed the Scoliosis Research Society 22r (SRS-22r) questionnaire. The mean change in the SRS-Schwab score was 0.4 units (baseline 1.1 vs. follow-up 1.5, P < 0.001) implying deterioration of the spinal deformity. The SRS-Schwab score decreased (n=76, 37%), remained the same (n=102, 50%) or improved (n=26, 13%). Four predictive factors for a change of sagittal alignment were found, of which the poor score in the SRS-22r function domain (P=0.049) and severe pelvic tilt (PT greater than 30°, P=0.006) predicted the change. This study showed the variability in how sagittal alignment of the spine change during the 10-year follow-up period. The ASD patients with poor self-assessed functional ability and disturbed pelvic position were associated with the risk of deterioration in spinopelvic alignment. The diversity in the natural course of ASD and the known risk factors highlights the need for tailored advice when planning preventive treatment procedures for ASD patients. 3.

Gender Differences in the Relationship between Physical Activity, Postural Characteristics and Non-Specific Low Back Pain in Young Adults.

Background/Aim: University students are a particularly vulnerable population, as they spend increasing amounts of time sitting, which poses a major threat to their musculoskeletal health and posture. The aim of this cross-sectional study was to investigate gender differences in the relationships between physical activity (PA) and sedentary behavior, spinal curvatures and mobility, the endurance and balance of the trunk muscles, and the possible presence of non-specific low back pain (NS-LBP) in young adults aged 18-25 years. Methods: A total of 139 students completed all required tests. Results: Male students engaged in significantly more PA related to recreation, sports and leisure and were significantly more likely to be hyperkyphotic than female students. The more the male students participated in sports, the more pronounced the thoracic kyphosis. Female students had significantly more pronounced lumbar lordosis and anterior pelvic tilt that correlated with lumbar lordosis. Female students generally had significantly higher trunk extensor endurance and more balanced trunk musculature than males. NS-LBP correlated with PA in female students who generally had higher levels of NS-LBP than male students, with a statistically significant difference between those who practiced the most PA. Conclusions: Our results suggest that female students practice less PA and have pronounced lordosis and trunk extensor endurance, in contrast to males who practice more PA and have pronounced trunk flexor endurance and hyperkyphosis. Our findings suggest that more PA should be encouraged but implemented with caution and as an individualized gender-specific approach to prevent postural deformities and chronic musculoskeletal disorders, including NS-LBP.

The Effect of Night-time versus Full-time Bracing on the Sagittal Profile in Adolescent Idiopathic Scoliosis: A Propensity Score-matched Study.

Retrospective multicenter cohort study. To investigate the impact of night-time bracing (NTB) and full-time bracing (FTB) on the sagittal profile in adolescent idiopathic scoliosis (AIS) patients. Recent studies have shown that FTB in AIS patients may induce hypokyphosis. Whether this effect differs between NTB and FTB is unknown. We included skeletally immature AIS patients with main curves ranging from 20-45° treated with either NTB or FTB. The two cohorts were propensity-score matched on Risser stage, age, major curve size, and kyphosis at brace initiation. Coronal and sagittal radiographic parameters were gathered at the initiation and completion of brace treatment. Two-hundred fifty-seven patients were eligible for inclusion. The matched cohorts included 62 patients in each group. During bracing, the thoracic kyphosis increased from 31±11° to 35±13° in the NTB group compared to a decrease from 30±12° to 28±13° in the FTB group (P=0.011). Eight percent were hypokyphotic (<20°) after bracing in the NTB group compared to 24% in the FTB group (P=0.015). Pelvic incidence, sacral slope, and pelvic tilt were not significantly different between the groups. In the coronal plane, curve progression >50° was seen in 50% in the NTB group and 31% in FTB (P=0.028). We saw a small increase in thoracic kyphosis in the NTB group vs. a small decrease in the FTB group. Eight percent in the NTB group vs 24% in the FTB group showed substantial hypokyphosis after bracing. The impact of minor changes in thoracic kyphosis remains uncertain; however, a threefold difference in the occurrence of hypokyphosis is notable and merits further attention.

Acute Changes in Hamstring Injury Risk Factors After a Session of High-Volume Maximal Sprinting Speed Efforts in Soccer Players.

Maximal sprinting speed (MSS) overexposure is associated with increased risk of injury. This study aimed to describe changes in sprint performance-related factors and hamstring strain injury (HSI) risk factors after a high-volume sprinting session in soccer players. A high-volume sprinting session can induce acute changes in several sprint performance-related factors (sprint time and mechanical properties) and HSI risk factors (posterior chain muscle strength, hamstring range of motion, and dynamic lumbo-pelvic control [LPC], measured as changes in anterior pelvic tilt [APT] during maximal speed sprinting). Prospective observational case series. Level 4. Fifteen active male amateur soccer players participated. Changes in sprint performance-related factors and HSI risk factors were examined for 72 hours after high-volume MSS efforts (H-VMSSE) using a soccer-contextualized multifactorial approach. Muscle damage proxy markers (hamstring perceived soreness and creatine kinase) were also examined. H-VMSSE induced decrements in sprint performance-related factors. Significant reductions in theoretical maximal horizontal velocity (P < 0.01; effect size [ES], -0.71) and performance (P = 0.02; ES, -0.59) were observed for 48 and 72 hours after H-VMSSE. Small but significant reductions in posterior chain muscle force-generating capacity were detected for 48 and 72 hours after H-VMSSE for the nondominant (P < 0.03; ES, -0.60) and dominant (P < 0.04; ES, -0.40) leg. Finally, players exhibited persistent small, albeit nonsignificant (P = 0.06; ES, 0.53), decreases in dynamic LPC (APT increases) for 72 hours after H-VMSSE. H-VMSSE induced declines in both sprint performance-related factors and HSI risk factors. Sprinting can alter a player's anatomic structure by increasing APT during the maximum speed phase of the sprint. A soccer-contextualized multifactorial approach might allow for the regulation of MSS dosage depending on individual HSI risk factor status, thereby serving as a tailored "vaccine" for sprinting needs.

Clinical presentation of anterior pelvic tilt and trunk muscle endurance among patients with femoroacetabular impingement syndrome: a cross-sectional study.

Femoroacetabular impingement syndrome (FAIS) significantly affects the physical function and quality of life of the young and middle-aged population. Pelvic tilt and trunk muscle endurance are physical features poorly studied in FAIS. This study aimed to compare the anterior pelvic tilt and anterior, lateral, and posterior trunk muscles endurance between people with FAIS and healthy individuals, within FAIS sub types and between the symptomatic and asymptomatic hip in people with FAIS. Cross-sectional study. Participants were recruited and screened for potential eligibility at the Rehabilitation, Sports Medicine, and Physiotherapy Unit between April 2021 and February 2022. Sixty-nine patients with FAIS and 69 controls. A study adhering to STROBE guidelines recruited 138 participants (69 FAIS, 69 controls). The degree of pelvic tilt was measured by the palpation meter (PALM) tool. To assess trunk musculature endurance, isometric trunk tests described by McGill were performed (extension resistance test, flexion resistance test, and side plank test). Cases were classified based on FAIS subtypes. Differences between groups and subgroups were performed using t-tests and ANCOVA, respectively. Significant differences in anterior pelvic tilt were observed between the control and FAIS groups (P<0.001, d=0.72). Participants with FAIS exhibited greater pelvic tilt (MD=1.57, 95% CI=0.83 to 2.3). Trunk muscle endurance showed statistically significant differences (P<0.001, d=0.72) for posterior muscles. In comparisons between symptomatic and asymptomatic hips, significant differences were found in pelvic tilt (P<0.001, d=0.26) and lateral trunk muscle endurance (P<0.001, d=0.43). FAIS subtypes demonstrated significant differences in lateral trunk muscle endurance (P=0.002, η<inf>p</inf>2=0.209). This study found that patients with FAIS present large anterior pelvic tilt and lower posterior trunk muscle endurance. Although anterior pelvic tilt was comparable for all FAIS subtypes, Pincer-type with or without labral tear exhibited lower lateral trunk muscle endurance compared with Cam-type with or without labral tear. In addition, the symptomatic hip of FAIS patients showed lower lateral trunk muscle endurance compared to the asymptomatic hip. Incorporating rehabilitation strategies that address pelvic tilt and trunk muscle strengthening in individuals with FAIS might be considered as a potential means to improve these physical impairments, pending careful evaluation of their effectiveness.

Immediate Effects of Two Different Methods of Trunk Elastic Taping on Pelvic Inclination, Trunk Impairment, Balance, and Gait in Stroke Patients.

Background and Objectives: Stroke patients often experience changes in their pelvic tilt, trunk impairments and decreased gait and balance. While various therapeutic interventions have been attempted to improve these symptoms, there is a need for interventions that are easy to apply and reduce the physical labor of physical and occupational therapists. We aimed to investigate the immediate effects of two different methods of trunk elastic taping on the pelvic inclination, trunk impairment, balance, and gait in chronic stroke patients. Materials and Methods: We performed a single-blind randomized controlled trial involving 45 patients with chronic stroke. Participants were randomly assigned to one of three groups: forward rotation with posterior pelvic tilt taping (FRPPT, n = 14), backward rotation with posterior pelvic tilt taping (BRPPT, n = 14), or placebo taping (PT = 14). This study was conducted from December 2023 to January 2024. All the measurements were performed twice: before the intervention and immediately after the intervention. The pelvic inclination was assessed using the anterior pelvic tilt angle. The trunk impairment scale (TIS) was used to measure the trunk impairment. The balance and gait were evaluated using a force plate and walkway system. Results: The pelvic inclination was significantly different in the FRPPT and BRPPT groups compared to the PT group (p < 0.05, p < 0.001). The TIS and gait were significantly increased in the FRPPT group compared to the PT group (p < 0.05). The balance significantly improved in the FRPPT and BRPPT within groups (p < 0.05). Conclusions: Two different methods of posterior pelvic tilt taping improved the anterior pelvic tilt in chronic hemiplegic stroke patients compared with PT, and the FRPPT method also improved the trunk impairment and gait. Therefore, posterior pelvic tilt taping can be used as an intervention with immediate effect.