Hip Extension Range Research Articles

Study the Immediate Effects of “Primal Reflex Release Technique™” Versus “Neural Tissue Mobilization” on Hip Flexor Tightness in Individuals with a Sedentary Lifestyle

Background: An inactive life can lead to various problems, such as tightness of muscles, decreased joint mobility, and decreased pliability, which can hinder daily activities. Prolonged sitting puts a lot of force on the muscles, increasing the risk of injury. Studies have shown that many people with desk jobs have tight iliopsoas muscles, resulting in lower strength, restricted hip movement, increased pelvic tilt, and excessive lower back curvature. Objective: This study investigates the immediate effectiveness of PRRT™ and NTM on hip flexor tightness in individuals with a sedentary lifestyle. The goal is to determine the most effective treatment approach to alleviate hip flexor tightness, thereby reducing associated risks and improving the quality of life for sedentary individuals. Study Design: Double-blinded Comparative Study Study Settings: In and around the Himalayan Institute of Medical Sciences, Dehradun Participants: 60 individuals with a sedentary lifestyle having tight hip flexors in the age group 18-45. Outcome measures: Hip Flexion Angle measured while performing Modified Thomas Test, Hip Extension Range. Result: A significant improvement is seen in hip flexion angle (p-value <0.001) and prone hip extension range (p-value <0.001) in both Groups A and B. However, on analysing and comparing the post-intervention results of both groups, no major difference was found in the outcome variables (p-value>0.05). Conclusion: This study concluded that both techniques are equally effective in reducing hip flexor tightness with a sedentary lifestyle and can mitigate associated risks and enhance the quality of life for sedentary individuals. KEYWORDS: Hip Flexors, Iliopsoas, PRRT, Neural Tissue Mobilization, Sedentary Lifestyle, Tightness.

Use of the Modified Thomas Test for Hip Flexor Stretching: What Are the Acute and Prolonged Effects?

Background/Objectives: The flexibility deficits of hip flexors have been identified as potential biomechanical risk factors for the lumbo–pelvic–hip complex, with postural repercussions on the trunk and lower limbs. The purpose of this study was to conduct a single gravity stretching experiment and to monitor its acute and prolonged effects. Methods: The sample comprised 14 healthy participants (8 females and 6 males). Data were collected during two-day measurement sessions. These analyzed via Kinovea software. The single intervention (i.e., gravity stretching) was performed on the first day. A modified Thomas test was used at the same time in two ways, both as a measurement and as an intervention tool. Stretching was achieved by relaxing in a position to perform the modified Thomas test where, each participant lies completely relaxed for 3 min, allowing gravity to stretch the hip flexors of the examined limb. Results: After intervention, a significant acute increase in hip extension range of motion and a decrease in knee extension range of motion were found. We did not find any significant prolonged effects; moreover, after 48 h, the hip range of motion almost returned to the initial value. Conclusions: A single 3 min stretch is very effective in terms of achieving immediate changes in the range of motion, but insufficient for long-term improvements in flexibility.

Agreement in Knee Flexion and Hip Extension Range of Motion Assessment between Digital Goniometer and Video-based Motion Tracking Technology

Precise range of motion (ROM) measurements are critical for diagnosing musculoskeletal impairments, planning treatment strategies and monitoring rehabilitation progress. This study compares the reliability and accuracy of ROM measurements using the EasyAngle electronic goniometer device and the Kemtai pose estimation video-based motion tracking software. Participants performed hip extension and knee flexion movements, with measurements taken by two examiners using both tools. The results show that both EasyAngle and Kemtai provide high inter-repetition reliability for knee flexion (ICC 0.93 and. 0.91) and hip extension (ICC 0.96 and 0.93). Kemtai generally overestimated ROM compared to EasyAngle, with relative agreement ranging from poor to good (ICC = 0.71 for knee flexion, ICC = 0.66 for hip extension). Future development and research should focus on refining digital tools like Kemtai to enhance their accuracy and reliability. Given its low cost and ease of use, Kemtai could be a useful tool for clinical practice.

Reliability of Goniometric Techniques for Measuring Hip Flexor Length Using the Modified Thomas Test.

The modified Thomas test (MTT) is commonly used to assess the flexibility of hip musculature, including the iliopsoas, rectus femoris, and tensor fascia latae. This measurement is important to include in a comprehensive musculoskeletal examination. However, existing research shows conflicting results regarding its reliability, particularly due to variations in controlling pelvic tilt during testing, which may lead to inaccurate measurements of hip extension when quantifying the test outcomes. This study aimed to evaluate the intra- and inter-rater reliability of the Modified Thomas Test (MTT) in assessing hip flexor length using a goniometer. It was hypothesized that controlling for pelvic tilt would enhance the reliability of these measurements. Intra- and inter-rater reliability study. Sixty-four healthy individuals were recruited to participate in this study. The MTT was performed twice on each leg by both an experienced and a student physical therapist. Blinded goniometric measurements for hip extension range of motion (ROM) in the MTT position were taken with neutral pelvic tilt being enforced via palpation. A double-blind protocol was used where both examiners were unaware of each other's measurements and the goniometer was covered to blind the measuring therapist to the values as well. ROM values were entered into a Microsoft Excel spreadsheet and quantified using SPSS software. Statistical analysis included calculating Intraclass Correlation Coefficients (ICCs) and Standard Errors of Measurement (SEMs) using SPSS software. The study included 64 participants (mean age = 23.7 ± 4.34 years). The MTT demonstrated high intra-rater reliability (ICC = 0.911) and inter-rater reliability (ICC = 0.851). The SEMs indicated minimal variability around the mean scores. The average hip extension ROM measured was 5.43± 9.73 degrees. These results suggest that the MTT is a reliable tool for assessing hip flexor length in clinical practice, particularly when pelvic tilt is controlled. These results have important implications for accurately testing orthopedic limitations that can contribute to low back, hip, and knee pain. 3.

Examining Movement Patterns, Skeletal Muscle Mass, and Hip Mobility in Office Workers With or Without Lower Back Pain: An Analytical Cross-Sectional Study.

The purpose of this study was to clarify the relationship between Functional Movement Screen (FMS), skeletal muscle mass, and hip mobility in office workers with or without chronic lower back pain (LBP), as well as to determine whether the above items differed between office workers with or without chronic LBP. This study utilized an analytic cross-sectional design. The participants were 35 office workers (14 in the LBP group and 21 in the non-lower back pain group, or NLBP) who were willing to cooperate with the request for cooperation in this study. Movement patterns were assessed by FMS and skeletal muscle mass was measured by bioelectrical impedance analysis. Hip mobility was measured by prone hip extension (PHE) and straight leg raising. The correlations between each item and differences in the presence or absence of LBP were analyzed. The LBP and NLBP groups showed different correlations (p<0.05) between total and subcategory scores and skeletal muscle mass. Total FMS score (p=0.02, r=-0.40) and PHE angle (p=0.01, r=0.43) were significantly higher in the LBP group than in the NLBP group. The FMS shows different relationships between total and subcategory scores and skeletal muscle mass for office workers with or without LBP. In addition, office workers with LBP may have different movement patterns and greater hip extension range of motion than those without LBP.

The effects of knee brace use on landing error, balance, and crossover hop test in healthy athletes

Objective: In this study, it was aimed to examine the effects of knee brace use on landing error after jumping, balance and crossover hop test (CHT) in healthy athletes. Methods: After recording the descriptive information of the healthy volunteer athletes and measuring the lower extremity joint range of motion, and the Q angle at the knee, participants were randomized. During the study, randomization was carried out as follows: those who did not use knee braces (GroupNon), those who used simple knee braces (GroupBasic) and those who used ligament-supported knee braces (GroupLig). Y-balance test of lower extremity (YBTL), CHT, and landing error scoring after jumping were applied to the participants. Results: A total of 56 professional athletes (GroupNon, n=19; GroupBasic, n=19; GroupLig, n=18) participated in the study. Characteristics of the participants did not reveal any difference (p&gt;0.05). Compared with the other two groups, lower hip extension range of motion was observed in GroupNon (p˂0.05), and no difference was observed in other lower extremity descriptive data (p&gt;0.05). Furthermore, comparing to the other two groups, a significant (p=0.014) increase was observed only in the velocity of CHT applied to the non-dominant extremity of GroupBasic. No significant difference was observed in the other evaluated parameters (p&gt;0.05). As a result of intra-group correlation analyses, different levels of relationship were determined between the landing results after the jumping and various biomechanical properties according to the choice of knee brace (p˂0.05). Conclusion: It would be appropriate to choose the knee brace to be used in healthy athletes by taking into account the biomechanical defining characteristics of the athlete.

Effects of different slopes on hip and ankle biomechanics of replaced and non-replaced limbs of patients with total knee arthroplasty during incline ramp walking

Although knee biomechanics has been examined, hip and ankle biomechanics in incline ramp walking has not been explored for patients with total knee arthroplasty (TKA). The purpose of this study was to investigate the hip and ankle joint kinematic and kinetic biomechanics of different incline slopes for replaced limbs and non-replaced limbs in individuals with TKA compared to healthy controls. Twenty-five patients with TKR and ten healthy controls performed walking trials on four slope conditions of level (0°), 5°, 10° and 15° on a customized instrumented ramp system. A 3x4 (limb x slope) repeated analysis of variance was used to evaluate selected variables. The results showed a greater peak ankle dorsiflexion angle in the replaced limbs compared to healthy limbs. No significant interactions or limb main effect for other ankle and hip variables. The peak dorsiflexion angle, eversion angle and dorsiflexion moment were progressively higher in each comparison from level to 15°. The peak plantarflexion moment was also increased with each increase of slopes. Both the replaced and non-replaced limbs of patients with TKA had lower hip flexion moments than the healthy control limbs. Hip angle at contact and hip extension range of motion increased with each increase of slopes. Peak hip loading-response internal extension moment increased with each increase in slope and peak hip push-off internal flexion moment decreased with each increase of slope. Our results showed increased dorsiflexion in replaced limbs but no other compensations of hip and ankle joints of replaced limbs compared to non-replaced limbs and their healthy controls during incline walking, providing further support of using incline walking in rehabilitation for patients with TKA.

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

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

Acute Effect of Improved Hip Range of Motion on Maximum Hip Angle in Pole Vaulting: A Pilot Study

Background: Large maximum hip flexion and extension range of motion is considered effective in preventing injury in pole vaulters. Nonetheless, whether the improvement in hip flexion and extension range of motion changes their hip joint angle during pole vaulting remains unclear. Objectives: The present study aimed to clarify the acute effects of intervention for hip flexion and extension range of motion in pole vaulters on the maximum hip joint angle during pole vaulting. Methods: Seventeen male pole vaulters who underwent the same intervention for hip range of motion were included. The maximum hip joint angle during the pole vault from the touchdown of the last step of the run-up to the pole straightening was calculated from videos taken pre- and post-intervention and was subsequently compared. The pole vaulters cleared bungee bars that were set at the height of 90% of their personal best record. Three types of self-massages were used to improve the hip flexion and extension range of motion, and an active straight leg raise exercise was also performed. All intervention programs were completed in approximately 25 min on an experimental day, and all interventions were monitored by the examiner. Results: No significant improvements were observed between pre and post-intervention hip range of motion. The magnitude of change in the range of motion of active hip flexion was significantly correlated with the magnitude of change in the maximum hip flexion angle during pole vaulting pre-and post-intervention (P = 0.002, r = 0.687). Conclusions: Athletes should find ways to improve their active range of motion to prevent injuries and improve their performance. Coaches and athletic trainers should adopt an active range of motion as an indicator to control athlete conditioning.

EFFECTS OF A SEDENTARY LIFESTYLE ON HIP EXTENSION AMONG GENERAL POPULATION

Objective: To assess the effects of a sedentary lifestyle on hip extension among general population. Methodology: A cross-sectional study was conducted for this research in which 163 participants were tested for this study. In addition, sitting behaviour and physical activity patterns were assess using the Global Physical Activity Questionnaire (GPAQ). Cut-off points were defined for low/high physical activity (150 min per week), prolonged sitting (&gt;7 hours per day), and minimal sitting, and high activity &amp; prolonged sitting. Results: Overall 163 participants were included in which 76 males and 87 females were selected for the study. The mean (SD) of age was 29(7.36) and the mean BMI was 2.27 kgm-2. The majority of the individuals fall in the moderate level of physical activity (&gt;150 hrs. Per week). The mean Hip extension ROM was 18.14o. The majority of the participants have prolonged sitting activities. The majority of the individuals have a low level of physical activity and have a sedentary lifestyle. Conclusion: Sedentary lifestyle results in decreased mobility and other comorbidities we concluded that the individuals that do prolong sitting and do less physical activity have a decrease in hip extension range of motion. Key Words: Hip flexors, hip extensors, hip extensions, stiffness, sitting behaviour, physical activity

Prospective Analysis of Functional and Structural Changes in Patients with Spinal Muscular Atrophy-A Pilot Study.

Spinal muscular atrophy (SMA) is a rare, autosomal recessive neuromuscular disease. Recent years have seen a significant development of therapeutic options for SMA patients. With the development of treatment methods, it has become necessary to adapt a physiotherapeutic approach to the evolving clinical picture of SMA patients. We presented an analysis of 40 SMA patients undergoing pharmacological treatment, examined twice in an average interval of 5 months. Twelve patients (non-sitters) were evaluated using CHOP-INTEND, while 28 (sitters) were tested using the Hammersmith scale. The research protocol consisted of measurements of upper and lower limb ranges of motion, and four tests for early detection of musculoskeletal changes. Both non-sitters and sitters patients showed motor improvement between the first and second examinations. Favorable changes in range of motion parameters were noted in most children, except for hip extension (HE) range, which deteriorated. An association was also observed between scale scores and the presence of contractures in the hip and knee joints depending on the group studied. Our findings showed that the presence of contractures at the hip and knee joint negatively affected functional improvement as measured by the scale scores.

Determining the hip joint isokinetic muscle strength and range of motion of professional soccer players based on their field position.

BackgroundSoccer players’ physical and physiological demands vary based on their field position. Although the hip joint has an important role in soccer, little information is available about the strength and flexibility of the hip joint based on player positions. Therefore, this study aims to investigate the differences in muscle strength and flexibility of the hip joint of professional soccer players based on their field position.MethodsNinety-six professional soccer players from Saudi Arabia were divided into four groups (goalkeepers, defenders, midfielders, and attackers), with 24 participants in each group based on their field position. The Modified Thomas test was used to measure the hip extension range of motion (ROM), and muscle strength was assessed by an Isokinetic dynamometer.ResultsThere were no statistically significant differences in the isokinetic strength at the hip joint movements between goalkeepers, defenders, midfielders, and attackers (p ≥ 0.05). At the same time, there was a significant difference between groups in the hip extension ROM (p ≤ 0.05). according to different player positions. Post hoc tests reported significant differences between goalkeepers and defenders (p ≤ 0.05), midfielders (p ≤ 0.05), and attackers p ≤ 0.05). At the same time, there were no significant differences between defenders and midfielders (p ≥ 0.05), defenders and attackers (p ≥ 0.05), and midfielders and attackers (p ≥ 0.05).ConclusionEven though there was no significant difference in isokinetic strength, there was a significant difference in hip extension ROM among players based on field position. This study may help coaches and trainers to recognize the strengths and weaknesses of players and design training programs to rectify the weaker components and improve players’ performance in different playing positions.

Efficacy of Single Stretching Session of Iliopsoas Using Proprioceptive Neuromuscular Facilitation Versus Muscle Energy Technique on Low Back Pain in Patients With Lumbar Hyper-Lordosis.

Background and objectivesOne of the most frequent conditions for which people seek physiotherapy treatment is low back pain (LBP). When the aetiology of low back pain is whittled down to mechanical factors, pelvic tilting becomes apparent. The iliopsoas muscle is the key to relieving LBP in such circumstances, and since it is tightened, we concentrated on stretching it adequately in this study. Proprioceptive neuromuscular facilitation (PNF) and muscle energy technique (MET) are two stretching techniques that we have compared for this purpose. There are many other stretching techniques available, but the evidence has proven these two to be the most effective.MethodsThe participants in the study were those between the ages of 18 and 60 who had exaggerated lumbar lordosis, or LBP, and met the inclusion criteria. There were two groups created: A and B. PNF and traditional physiotherapy was used to manage the participants in group A, and MET and traditional physiotherapy were used to manage the participants in group B. Each group underwent the same pre-and post-tests, which included the Numerical Pain Rating Scale (NPRS) to assess pain intensity; a universal goniometer to measure hip joint extension range of motion (ROM) to assess iliopsoas flexibility; and a side-lying X-ray to measure the lumbosacral angle (LSA) to determine the angle of lumbar lordosis.ResultIn both the stretching interventions, i.e., PNF and MET, there were statistically significant differences in pain, hip extension range of motion, and lumbar lordosis angle (P > 0.0001). However, for the PNF group, the difference between the pre-and post-test was greater than that for the MET group.ConclusionThe current study, which included 100 participants, demonstrated that both PNF and MET are remarkably effective for loosening the tight iliopsoas. A comparison of both techniques showed that the PNF group had benefited significantly more than the MET group.

Acute Effects on Some Performance Parameters of The Dry Cupping Therapy by Soccer Players

Objective: This study aimed to examine the acute effect of dry cupping therapy applied to the hamstring muscle in footballers on flexibility, jumping, strength and range of motion.Materials and Methods: 25 male athletes with an average age of 18.80 ± 0.41 in the U-19 football team, one of the infrastructure teams of Yukatel Denizlispor club, voluntarily participated in this study. Soccer players first evaluated flexibility, range of motion, jumping and strength tests bilaterally. All athletes were administered a 10-minute dry cupping along the muscle bilaterally to the hamstring muscle after their initial change. Then all initial assessments were repeated and data recorded.Results: Dry cupping therapy was found to have a statistically significant effect on the flexibility parameter of the hamstring muscle and bilateral evaluated knee flexion and hip extension range of motion (p&amp;gt;0.05). Dry cupping therapy was found to have no statistically significant effect on the strength parameters of knee flexion and hip extension, which were evaluated bilaterally and jumping parameters (p&amp;gt;0.05).Conclusion: We concluded that, dry cupping therapy is a useful method as a non-invasive, easy-to-apply and economical complementary medicine application to increase flexibility and range of motion parameters in football players.

Is Maximum Available Hip Extension Range of Motion of the Residual Limb Reached During Passive Prone Lying in the Acute Stage After Dysvascular Transtibial Amputation?

ABSTRACT Introduction Individuals after a transtibial amputation (TTA) are at risk to develop a hip flexion contracture, which may adversely affect future ambulation with a prosthesis. Although patients have traditionally been advised to lie prone to maintain or improve hip extension, compensatory pelvic tilting may occur in prone lying (PL). We sought to compare hip extension range of motion (ROM) in PL to the modified Thomas test (MTT) position, because research implies that, in the MTT, patients are better able to control for compensatory pelvic tilting. We hypothesized that individuals after a TTA would have a greater peak hip extension angle in the MTT position compared with the PL position. Methods Ten individuals after a dysvascular TTA, mean age of 60 ± 8.42 years, participated in this study. The same physical therapist marked the femur and pelvis for goniometric measurement of peak hip extension angle by 12 raters blinded to each other's measurements. The markers remained unchanged as six raters measured all participants in PL and six different raters measured all participants in the MTT position. Results and Discussion The intraclass correlation (ICC) indicated high interrater reliability between the raters for the PL and MTT positions (ICC = 0.985 for PL and 0.976 for MTT). The average peak hip extension angle in PL was −14.0° ± 13.3°, standard error of mean = 4.3°; and in the MTT position was −8.6° ± 15.3°, standard error of mean = 4.8° (the negative mean connotes that, on average, participants did not have hip extension to neutral for either condition). We found a mean of 5.4° ± 6.6° more hip extension ROM for the MTT position compared with PL (P = 0.028). Conclusions Our findings show that, on average, patients after a TTA have significantly greater peak hip extension angle in the MTT position compared with the PL position. Thus, passive PL may not be as effective of a stretching position for preventing a hip flexion contracture after a TTA, because PL does not always extend the patient's hip to its maximum available ROM, due to the reduced ability to control the pelvis from tilting anteriorly. Clinical Relevance Adequate hip flexor length is positively correlated with gait parameters, which include increased velocity and step length in people using a prosthesis after transtibial amputation. This study implies that the MTT position may be a better method for improving and maintaining hip flexor length over the traditional strategy of passive PL.

Effects of Health Qigong Exercise on Lower Limb Motor Function in Parkinson's Disease.

PurposeThis study explored the effects of Health Qigong exercise on lower limb motor function in patients with Parkinson's disease (PD).Patients and MethodsA total of 40 patients with PD were recruited and randomly allocated into the experimental group and the control group. The experimental group completed an intervention of Health Qigong exercise over 12 weeks, while the control group did not perform any regular physical activity. Data relating to gait, lower-limb joint range of motion, Timed Up and Go, as well as scores for motor function scale from the Unified Parkinson's Comprehensive Rating Scale III (UPCRS III) before and after the intervention were collected for Repeated Measure ANOVA.ResultsCompared to the control group, Health Qigong exercise improved the constant- and high-speed stride length and gait velocity of patients, but not constant- and high-speed stride frequency. Left and right hip flexion and extension range were improved as well as left and right knee flexion range. Finally, Timed Up and Go time became significantly slower and UPCRS III score significantly decreased.ConclusionHealth Qigong exercise can improve walking ability and lower limb joint range of motion in patients with PD, lessen motor difficulties, and improve the quality of life. This non-pharmacological exercise intervention may be a useful adjustment treatment for PD.

Associations between potentially modifiable clinical factors and sagittal balance of the spine in older adults from the general population.

Spinal sagittal balance is associated with back pain and quality of life. Enhancing understanding of the clinical factors associated with sagittal balance is essential for guiding the development of effective non-operative treatment. We aimed to evaluate the associations between spinal sagittal balance and potentially modifiable clinical factors and interactions between current back pain and the evaluated clinical factors. We conducted a cross-sectional study where sagittal alignment, measured radiographically by EOS, was defined by sagittal vertical axis (SVA). The clinical factors included non-radiographic (NR) lumbar lordosis angle, balance (Berg balance scale), hip and back extension range of motion (ROM) and extensor strength, and back pain. Pearson's correlation coefficients and multivariable regression analyses were conducted in 63 adult participants (70% female, mean age 73 (SD 8.6) years) from the general population. We identified correlations between SVA and age (r = 0.4, p < 0.001), body mass index (BMI) (r = 0.3, p = 0.008), balance (r = - 0.5, p < 0.001) and NR lumbar lordosis angle (r = - 0.5, p < 0.001). The final model (R2 = 58%) identified that, after controlling for age and BMI, larger SVA was associated with lower NR lumbar lordosis (R2 = 15%, p < 0.001), poorer balance (R2 = 7%, p = 0.02), greater hip extensor strength (R2 = 4%, p = 0.053), and among people with back pain, NR lumbar extension ROM (R2 = 3%, p = 0.034). Hip ROM and lumbar strength were not significant. Reduced NR lumbar lordosis magnitude and ROM, balance and hip strength are associated with SVA; however, it is unclear if these factors are compensatory, contributing, or modifiable. Hence, future longitudinal studies are needed.

A rat model of hip joint contracture induced by mono-articular hip joint immobilization

BackgroundTo elucidate the formation process and therapeutic targets of hip flexion contracture, we developed a rat model of hip flexion contracture induced by hip mono-articular immobilization. MethodsKirschner wires inserted into the femur and hip bone were anchored at the hip in a flexed position in the immobilization groups and unanchored in the sham groups for up to four weeks. Age-matched untreated rats were used as controls. Hip extension range of motion (RoM) was measured at three different extension moments (7.5, 15, and 22.5 N•mm) in each successive myotomy step as follows: before myotomy, after sequential myotomy of the tensor fascia lata, quadriceps muscle, iliopsoas muscle, and after myotomy of all residual muscles (the gluteus medius and adductor muscles). Histological analysis of the hip joint was also performed. FindingsAfter four weeks of immobilization, the RoM before myotomy at 22.5 N•mm was significantly decreased by 29° compared with controls, and this value was unaltered in the sham group. Analyses following serial myotomy suggested that the structures responsible for myogenic contracture were the tensor fascia lata, iliopsoas, gluteus medius, and adductor muscles because the RoMs were increased by these myotomies. Unexpectedly, arthrogenic contracture was not detected at moments other than at 7.5 N•mm, even after four weeks of immobilization. Histological analysis confirmed that pathological changes were not apparent in the anterior capsule of the hip joint. InterpretationThe present findings suggest that myogenic contracture may be an important therapeutic target for immobilization-induced hip flexion contracture.

Prone vs Supine Positioning for Femoral Derotation Osteotomy: Kinematic and Physical Examination Outcomes Suggest Both Can Achieve Desired Results.

Background: Femoral derotation osteotomy (FDO) for correction of internal rotation gait resulting from cerebral palsy (CP) can be performed with the patient in the prone or supine position. It is not known whether patient positioning during FDO affects the change in hip rotation. Purpose/Questions: We sought to compare the change in hip rotation following FDO performed on patients with CP in the prone or supine position through kinematic analysis. Methods: We conducted a consecutive retrospective cohort study of children with CP, ages 3 to 18 years and with Gross Motor Function Classification System (GMFCS) levels I to III, who underwent prone or supine FDO and pre- and postoperative motion analysis. The prone group included 37 patients (68 limbs) between 1990 and 1995. The supine group included 26 patients (47 limbs) between 2005 and 2015. The groups were matched for gender, age, and GMFCS level. The primary outcome was hip rotation in degrees during stance phase. Secondary outcomes included temporal-spatial parameters, hip abduction, hip and knee extension, and hip and knee passive range of motion (ROM). Results: The prone group had more bilateral patients (100%) than the supine group (81%). The supine group underwent more concomitant procedures. There was no difference between the prone and supine groups in postoperative stance hip rotation; both groups had significantly improved stance hip rotation, step width, and hip rotation passive ROM, pre- to postoperatively. Prone patients had improved postoperative hip extension, pelvic tilt, velocity, and cadence. Conclusions: There was no significant different in stance hip rotation between supine and prone FDO groups. Advocates of prone positioning for FDO suggest it allows more accurate assessment of rotation. Supine positioning may be more convenient when additional procedures are required. Based on our findings, either approach can achieve the desired result.

Investigation of multidirectional hip range of motion and hip motion asymmetry in individuals with idiopathic scoliosis with different curve patterns

BackgroundWhile some studies of the asymmetry of lower limbs in individuals with idiopathic scoliosis exist, there is a need for multidirectional studies conducted on hip joint range of motion and its relationship to curve patterns in idiopathic scoliosis. ObjectivesThis study analyzes the hip joint range of multidirectional motions, hip motion asymmetry and investigates them according to curve patterns in individuals with idiopathic scoliosis. MethodsThe sample included 108 females with idiopathic scoliosis. Participants were divided into three groups: double curves, single thoracic curve and single lumbar curve. The range of hip flexion and extension, abduction and adduction, and internal and external rotations were assessed actively and passively with a universal goniometer. The range of motion, left–right asymmetry and the mid-points of the ranges of motion were analyzed. ResultsThe passive range of the right hip abduction was higher in the thoracic curve group vs. the lumbar curve group. Active and passive ranges of hip extension were higher in the left hip vs. right hip. Active left–right asymmetry was higher than passive left–right asymmetry. ConclusionIndividuals with idiopathic scoliosis had different hip abduction motions according to curve pattern that originated from single curves. Left–right hip asymmetry was seen for the hip extension motion. Higher left–right asymmetry for active motion than passive motion in hip abduction may indicate a problem in motion perception in individuals with idiopathic scoliosis.