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1 Contribution of position of pelvis on femur to hip adduction angle. Pelvic drop is measured relative to the horizontal. Lateral pelvic shift over the fixed foot is measured as the distance from the calcaneal marker and the inter-ASIS marker defined midline and normalized to pelvic width to account for varying base of supports likely associated with greater pelvic width. Hip adduction is increased by either drop of the contralateral side of the pelvis (pelvic obliquity) or by translation of the pelvis towards the ipsilateral side.
Source publication
Background:
Lateral hip pain during single leg loading, and hip abductor muscle weakness, are associated with gluteal tendinopathy, but it has not been shown how or whether kinematics in single leg stance differ in those with gluteal tendinopathy.
Purpose:
To compare kinematics in preparation for, and during, single leg stance between individual...
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The aim of this study was to investigate the possible kinematic and muscular activity changes with maximal loading during squat maneuver. Fourteen healthy male individuals, who were experienced at performing squats, participated in this study. Each subject performed squats with 80%, 90%, and 100% of the previously established 1 repetition maximum (...
Citations
... Do-eun Lee, et al to assess hip abductor performance. Lateral pelvic shift is a motion that occurs during one-leg lifting, and with greater hip adduction on the standing side (contributing to lateral pelvic shift), optimal hip abduction force generation is provided according to the length-tension curve [12]. In addition, the lateral pelvic shift is closely related to the function of the Gmed because it reduces the moment arm of the body weight [35]. ...
... First, the position of the contralateral leg during measurement may have affected the hip abductor strength. To measure the hip abductor strength, the HHD is typically applied in the side-lying position, whereasAllison et al.[12] applied it in the supine position. The position of the non-measuring leg can influence the SHA strength of the testing side. ...
... In this study, we used the number of HAPCA as a variable indicating the hip abduction performance. In general, an HHD is used to measure force[12,22,31,32]. However, the HHD has a subjective effect on the measurement results depending on the user, and it is difficult to quantify the force in the absence of the HHD. ...
... The angle was marked as positive in calculations when the downward direction was toward the fused hip side and negative when the downward direction was toward the opposite side. The HAA was defined as the angle between the perpendicular angle of the line passing through the inferior tip of the bilateral pelvic teardrops and the long axis of the femur on the affected side 15 . This value was calculated with abduction regarded as a positive angle and adduction regarded as a negative angle. ...
To elucidate the changes in coronal lumbar‐pelvic‐femoral alignment after conversion total hip arthroplasty (THA) in patients with unilateral ankylosed hip. A retrospective radiologic study of 48 patients (48 hips) with unilateral hip arthrodesis who underwent conversion THA was conducted. Cobb’s angle of lumbar scoliosis (LS), the pelvic obliquity (PO) angle, and the hip adduction angle (HAA) on standing anterior–posterior spine‐pelvis‐hip radiographs were measured before and after THA. The differences of LS, PO, and HAA before and after THA were defined as ΔLS, ΔPO, and
ΔHAA, respectively. A paired samples t‐test or the Wilcoxon signed‐rank test were used to compare the absolute values of the LS, PO, and HAA between preoperative and postoperative groups. The Pearson’s correlation coefficient (r) or Spearman’s correlation coefficient (ρ) was calculated to
assess the relationship between ΔLS, ΔPO, and ΔHAA and possible associated factors. Significant differences were found in the preoperative LS (mean, 10.8° vs. 8.2°, p = 0.004), PO (median, 6.8° vs. 2.0°, p < 0.001), and HAA (median, 10.0° vs. 6.0°, p = 0.003). ΔLS was correlated with the preoperative LS(ρ= −0.621,p<0.001),PO(ρ= −0.580,p<0.001),andHAA(ρ= −0.467,p<0.001).ΔPOwas correlated with the preoperative LS (r = − 0.596, p < 0.001), PO (ρ = − 0.892, p < 0.001), and HAA
(ρ = − 0.728, p < 0.001). ΔHAA was correlated with the preoperative LS (r = − 0.583, p < 0.001), PO
(ρ = − 0.751, p < 0.001), and HAA (ρ = − 0.824, p < 0.001). LS, PO, and HAA were significantly improved after conversion THA. Greater improvement in LS, PO, and HAA can be expected in patients with larger preoperative LS, PO, and HAA values.
... Gluteus maximus primarily produces a hip extension moment (1), and gluteus medius and minimus primarily generate hip abduction and internal/external hip rotation depending on the hip flexion angle (2). Together, the gluteal muscles are critical for human movement, providing support and producing propulsion during locomotion (3), stabilizing the hip joint (4), and controlling the orientation of the pelvis during single-leg stance (5). Gluteal muscle weakness is associated with a number of hip and knee pathologies, such as femoroacetabular impingement syndrome (6), hip osteoarthritis (7), patellofemoral pain (8), and risk of anterior cruciate ligament injury (9). ...
Purpose:
This study aimed to compare and rank gluteal muscle forces in eight hip-focused exercises performed with and without external resistance and describe the underlying fiber lengths, velocities, and muscle activations.
Methods:
Motion capture, ground reaction forces, and electromyography (EMG) were used as input to an EMG-informed neuromusculoskeletal model to estimate gluteus maximus, medius, and minimus muscle forces. Participants were 14 female footballers (18-32 yr old) with at least 3 months of lower limb strength training experience. Each participant performed eight hip-focused exercises (single-leg squat, split squat, single-leg Romanian deadlift [RDL], single-leg hip thrust, banded side step, hip hike, side plank, and side-lying leg raise) with and without 12 repetition maximum (RM) resistance. For each muscle, exercises were ranked by peak muscle force, and k-means clustering separated exercises into four tiers.
Results:
The tier 1 exercises for gluteus maximus were loaded split squat (95% confidence interval [CI] = 495-688 N), loaded single-leg RDL (95% CI = 500-655 N), and loaded single-leg hip thrust (95% CI = 505-640 N). The tier 1 exercises for gluteus medius were body weight side plank (95% CI = 338-483 N), loaded single-leg squat (95% CI = 278-422 N), and loaded single-leg RDL (95% CI = 283-405 N). The tier 1 exercises for gluteus minimus were loaded single-leg RDL (95% CI = 267-389 N) and body weight side plank (95% CI = 272-382 N). Peak gluteal muscle forces increased by 28-150 N when exercises were performed with 12RM external resistance compared with body weight only. Peak muscle force coincided with maximum fiber length for most exercises.
Conclusions:
Gluteal muscle forces were exercise specific, and peak muscle forces increased by varying amounts when adding a 12RM external resistance. These findings may inform exercise selection by facilitating the targeting of individual gluteal muscles and optimization of mechanical loads to match performance, injury prevention, or rehabilitation training goals.
... Gluteus maximus primarily produces a hip extension moment (1), and gluteus medius and minimus primarily generate hip abduction and internal/external hip rotation depending on the hip flexion angle (2). Together, the gluteal muscles are critical for human movement, providing support and producing propulsion during locomotion (3), stabilizing the hip joint (4), and controlling the orientation of the pelvis during single-leg stance (5). Gluteal muscle weakness is associated with a number of hip and knee pathologies, such as femoroacetabular impingement syndrome (6), hip osteoarthritis (7), patellofemoral pain (8), and risk of anterior cruciate ligament injury (9). ...
... Nevertheless at the second half of stance under much smaller flexion angles, ACL force peaks at 0.76BW (75% of stance) that exceeds its maximum of 0.58BW evaluated at 25% in walking [66]. High activity in gastrocnemii that are also ACL antagonist [91,92] [31,72,[95][96][97][98][99][100][101][102][103][104][105][106][107][108][109]. The solid pink lines represent the input data used in our gait simulations [110] reported in this work for comparison. ...
About a third of knee joint disorders originate from the patellofemoral (PF) site that makes stair ascent a difficult activity for patients. A detailed finite element model of the knee joint is coupled to a lower extremity musculoskeletal model to simulate the stance phase of stair ascent. It is driven by the mean of measurements on the hip‐knee‐ankle moments‐angles as well as ground reaction forces reported in healthy individuals. Predicted muscle activities compare well to the recorded electromyography data. Peak forces in quadriceps (3.87 BW, body weight, at 20% instance in our 607 N subject), medial hamstrings (0.77 BW at 20%), and gastrocnemii (1.21 BW at 80%) are estimated. Due to much greater flexion angles‐moments in the first half of stance, large PF contact forces (peak of 3.1 BW at 20% stance) and stresses (peak of 4.83 MPa at 20% stance) are estimated that exceed their peaks in level walking by four‐ and two‐fold, respectively. Compared to level walking, ACL forces diminish in the first half of stance but substantially increase later in the second half (peak of 0.76 BW at 75% stance). Under nearly similar contact forces at 20% of stance, the contact stress on the tibiofemoral (TF) medial plateau reaches a peak (9.68 MPa) twice that on the PF joint suggesting the vulnerability of both joints. Compared to walking, stair ascent increases peak ACL force and both peak TF and PF contact stresses. Reductions in the knee flexion moment and/or angle appear as a viable strategy to mitigate internal loads and pain. This article is protected by copyright. All rights reserved.
... The transition phase requires hip abductor activation to assist with the lateral translation of the pelvic girdle while stance phase requires the hip abductors to control pelvic tilt. 42 In the setting of hip abductor weakness or pain with activation of the hip abductors, an individual may exhibit a Trendelenburg sign, meaning the contralateral hip will drop towards the floor, or a compensated Trendelenburg, meaning the patients trunk leans ipsilaterally to the stance leg (Figure 7). 43,44 Allison et al. 42 found individuals with gluteal tendinopathy exhibit greater hip adduction and ipsilateral pelvic shift in preparation for leg lift and greater hip adduction and less control over the pelvis during the stance phase. ...
... 42 In the setting of hip abductor weakness or pain with activation of the hip abductors, an individual may exhibit a Trendelenburg sign, meaning the contralateral hip will drop towards the floor, or a compensated Trendelenburg, meaning the patients trunk leans ipsilaterally to the stance leg (Figure 7). 43,44 Allison et al. 42 found individuals with gluteal tendinopathy exhibit greater hip adduction and ipsilateral pelvic shift in preparation for leg lift and greater hip adduction and less control over the pelvis during the stance phase. Other signs of hip abductor dysfunction include the need for upper or lower extremity support during the SLS task. ...
Greater trochanteric pain syndrome (GTPS) refers to pain in the lateral hip and thigh and can encompass multiple diagnoses including external snapping hip (coxa saltans), also known as proximal iliotibial band syndrome, trochanteric bursitis, and gluteus medius (GMed) or gluteus minimus (GMin) tendinopathy or tearing. GTPS presents clinicians with a similar diagnostic challenge as non-specific low back pain with special tests being unable to identify the specific pathoanatomical structure involved and do little to guide the clinician in prescription of treatment interventions. Like the low back, the development of GTPS has been linked to faulty mechanics during functional activities, mainly the loss of pelvic control in the frontal place secondary to hip abductor weakness or pain with hip abductor activation. Therefore, an impairment-based treatment classification system. is recommended in the setting of GTPS in order to better tailor conservative treatment interventions and improve functional outcomes.
Level of evidence:
Level V, clinical commentary.
... Other studies have reported that patients with hip OA have weak hip muscle strength (Arokoski et al., 2002;Marshall, Noronha, Zacharias, Kapakoulakis, & Green, 2016), which affects hip movement strategies when standing on one leg (Tateuchi et al., 2016). Traditionally, the hip movement strategy during standing has been investigated using body segment acceleration (Panzer, Bandinelli, & Hallett, 1995), hip joint angles (Allison et al., 2016;Mientjes & Frank, 1999), hip joint torque (Günther, Grimmer, Siebert, & Blickhan, 2009;Otten, 1999), force plates (Mok, Brauer, & Hodges, 2004), or electromyography (Imai et al., 2005;Panzer et al., 1995). Considering the evaluation of the hip movement strategy in the clinical setting, the segmental acceleration, a kinematic parameter which is an indicator of postural sway, has been used for movement analysis during standing (Ito, Horiuchi, Seguchi, & Hongo, 2015;Moe-Nilssen & Helbostad, 2002). ...
This study aimed to investigate the hip sway and the relationship between the center of pressure (CoP) and kinematic parameters regarding the time series scaling component α in patients with hip osteoarthritis (OA) during a one-leg standing task. The scaling exponent α , SD , hip sway maximal acceleration change, and balance performance, which was measured using CoP parameters, were compared between hip OA and control groups during a one-leg standing task. The relationships between balance performance with CoP parameters and kinematic parameters were investigated with the regression analysis. In the hip OA group, the scaling exponent α was smaller in the medial–lateral direction, and the SD and maximal amount of change in hip sway acceleration were larger in the anterior–posterior direction in the hip OA group. In this group, the CoP parameters were significantly associated with α in the medial–lateral direction (negatively) and in the anterior–posterior direction (positively). In the hip OA group, hip sway adaptability in the medial–lateral direction was limited, while the anterior–posterior direction showed greater movement.
... Embora estes questionários sejam utilizados rotineiramente em estudos longitudinais, eles têm aplicabilidade limitada na seleção de intervenções objetivas de melhora da funcionalidade dos membros inferiores. A diminuição da força muscular tem sido relatada como sendo um resultado físico objetivo e frequente 4,5 . Estudo 5 sugeriu que pacientes com dor crônica no quadril tendem a ter reduções do pico de força do rotador interno, rotador externo e abdutor do quadril tanto nos membros afetados como contralaterais quando comparados com indivíduos saudáveis. ...
... Os músculos periarticulares são importantes estabilizadores dinâmicos da articulação do quadril e podem ser responsáveis por disfunções de movimento do quadril e da região lombo-pélvica quando são limitados em sua capacidade de gerar força ou quando há déficits de controle neuromuscular 8 porque tendem a gerar uma sobrecarga biomecânica nas estruturas intra-articulares 8 . Embora uma boa capacidade de gerar força muscular e um bom controle motor seja primordial para a funcionalidade e manutenção da qualidade de vida de pacientes com dor crônica no quadril 4,5 , nenhum estudo procurou estabelecer uma possível associação entre a capacidade de gerar força muscular do quadril e o nível de capacidade funcional relatado por pacientes com dor crônica no quadril. Tais dados poderiam ajudar a otimizar os exercícios de fortalecimento muscular em programas destinados a melhorar a função motora de pacientes com dor crônica no quadril. ...
BACKGROUND AND OBJECTIVES:
This study aimed to identify the association between hip muscle strength and the scores from subjective functional and psychological evaluation questionnaires in patients with chronic hip pain.
METHODS:
Fifty-fivepatients with painful hip injuries (30 males) performed isometric peak strength tests of the abductors, extensors, and internal and external rotators of the hips with a hand-held dynamometer. The degree of functionality was measured by the Hip Outcome Score (HOS) and Lower Extremity Functional Score (LEFS), pain was estimated by the Visual Analog Scale (VAS) and kinesiophobia was calculated using the Tampa questionnaire. The Pearson correlation coefficient was used (alfa=5%) to test the associations between the muscle strength and the scores from the questionnaires.
RESULTS:
There were significant correlations between the strength of all four hip muscles and the HOS (r>0.29). Only the hip external rotators showed a significant correlation with pain (r=-0.30). No significant correlations were found for LEFS (r<0.24) and Tampa questionnaires (r¬0.15).
CONCLUSION:
The reduction in peak strength of the hip extensors, abductors and external rotators was associated with a reduction in the level of hip functionality but did not correlate with neither the level of overall functionality of the lower limbs nor the degree of kinesiophobia. Also, a reduction of hip external rotators strength was related to an increase in the intensity of pain.
... Pelvic angles were extracted using a rotation-obliquity-tilt sequence as recommended by Baker (Baker, 2001). Lateral pelvic translation was calculated according to Allison and colleagues (Allison et al., 2016), providing a relative quantification of the position of the foot to the midline of the participant. Trunk translation denotes the C7 marker relative to the calcaneal marker on the stance foot expressed in cm. ...
... A steady SLS was defined by the 120-ms window with the least medial-lateral movement of the ground reaction force (GRF) data from the force plate under the standing foot. This was decided by manual inspection, and trials were ignored if participants were unable to maintain SLS (Allison et al., 2016). Neutral stance represented self-selected double limb stance 450 frames prior to foot-off. ...
... Neutral stance represented self-selected double limb stance 450 frames prior to foot-off. Foot-off was defined using a threshold of < 20 N for the vertical GRF underneath the lifted leg (Allison et al., 2016). The weight-shift phase was defined between neutral stance and foot-off and the leg lift phase between foot-off and end of lift (EOL). ...
Background:
Pelvic girdle pain is prevalent during pregnancy, and women affected report weight-bearing activities to be their main disability. The Stork test is a commonly used single-leg-stance test. As clinicians report specific movement patterns in those with pelvic girdle pain, we aimed to investigate the influence of both pregnancy and pelvic girdle pain on performance of the Stork test.
Methods:
In this cross-sectional study, 25 pregnant women with pelvic girdle pain, 23 asymptomatic pregnant and 24 asymptomatic non-pregnant women underwent three-dimensional kinematic analysis of the Stork test. Linear mixed models were used to investigate between-group differences in trunk, pelvic and hip kinematics during neutral stance, weight shift, leg lift and single leg stance.
Findings:
Few and small significant between-group differences were found. Pregnant women with pelvic girdle pain had significantly less hip adduction during single leg stance compared to asymptomatic pregnant women (estimated marginal means (95% confidence intervals) -1.1° (-2.4°, 0.3°) and 1.0° (-0.4°, 2.4°), respectively; P = 0.03). Asymptomatic pregnant women had significantly less hip internal rotation compared to non-pregnant women 4.1° (1.6°, 6.7°) and 7.9° (5.4°, 10.4°), respectively (P = 0.04) and greater peak hip flexion angle of the lifted leg in single leg stance 80.4° (77.0°, 83.9°) and 74.1° (70.8°, 77.5°), respectively (P = 0.01). Variation in key kinematic variables was large across participants in all three groups.
Interpretation:
Our findings indicate that trunk, pelvic and hip movements during the Stork test are not specific to pregnancy and/or pelvic girdle pain in the 2nd trimester. Instead, movement strategies appear unique to each individual.
... The inclusion criteria for the present study consisted of several parameters: unilateral lateral hip pain (in the absence of groin pain) 19 ; tenderness upon palpation at the greater trochanter 20 ; diagnosis and referral by a general practitioner; and pain over the last 3 months before assessment. The exclusion criteria consisted of several comorbid disease-related parameters: a radiologic diagnosis of hip or knee osteoarthritis; presence of another musculoskeletal injury or neurologic or systemic condition that could affect balance or gait 19 ; cognitive impairment or psychiatric disease; and surgical or traumatic history at the hip or corticoid local injection during the 6 months before assessment. ...
... The inclusion criteria for the present study consisted of several parameters: unilateral lateral hip pain (in the absence of groin pain) 19 ; tenderness upon palpation at the greater trochanter 20 ; diagnosis and referral by a general practitioner; and pain over the last 3 months before assessment. The exclusion criteria consisted of several comorbid disease-related parameters: a radiologic diagnosis of hip or knee osteoarthritis; presence of another musculoskeletal injury or neurologic or systemic condition that could affect balance or gait 19 ; cognitive impairment or psychiatric disease; and surgical or traumatic history at the hip or corticoid local injection during the 6 months before assessment. ...
Objective
Greater trochanteric pain syndrome (GTPS) is a common condition that can cause lateral hip pain. The single-leg-squat test (SLST) may be used by physicians in primary care environments to evaluate patients’ dynamic stability. The aim of this study was to evaluate the dynamic stability and strength of lateral abduction hip movements in primary care patients with GTPS in relation to their perceived pain interference in life.
Methods
A descriptive observational study was carried out in a primary health care center. Fifty-four participants with GTPS were included in this study and divided into lower- and higher-interference groups (n = 30 and 19, respectively) according to the Graded Chronic Pain Scale. Participants were evaluated for their lateral abduction hip strength and the SLST.
Results
The SLST showed a statistically significant difference between groups with respect to hip-joint posture and movement level (P = .043) but not for other SLST domains or lateral abduction hip strength (P > .05).
Conclusion
Patients with GTPS with more pain interference in their lives had poorer dynamic stability with respect to hip-joint posture and movements based on the SLST but did not present impaired lateral hip abduction strength in comparison with those who perceived lower pain interference in life.
