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Purpose: The aim of the study was to determine the restoration of hip biomechanics through lateral offset, leg length, and acetabular component position when comparing non-arthroplasty surgeons (NAS) to elective arthroplasty surgeons (EAS). Methods: 131 patients, with a femoral neck fracture treated with a THA by 7 EAS and 20 NAS, were retrospectively reviewed. 2 blinded observers measured leg-length discrepancy, femoral offset, and acetabular component position. Multivariate logistic regression models examined the association between the surgeon groups and restoration of lateral femoral, acetabular offset, leg length discrepancy, acetabular anteversion, acetabular position, and component size, while adjusting for surgical approach and spinal pathology. Results: NAS under-restored 4.8 mm of lateral femoral offset (43.9 ± 8.7 mm) after THA when compared to the uninjured side (48.7 ± 7.1 mm, p = 0.044). NAS were at risk for under-restoring lateral femoral offset when compared to EAS (p = 0.040). There was no association between lateral acetabular offset, leg length, acetabular position, or component size and surgeon type. Conclusions: Lateral femoral offset is at risk for under-restoration after THA for femoral neck fractures, when performed by surgeons that do not regularly perform elective THA. This indicates that lateral femoral offset is an under-appreciated contributor to hip instability when performing THA for a femoral neck fracture. Lateral femoral offset deserves as much attention and awareness as acetabular component position since a secondary analysis of our data reveal that preoperative templating and intraoperative imaging did not prevent under-restoration. [ABSTRACT FROM AUTHOR]

BACKGROUND: Traction-and-vibration-therapy (TVT) relieves pain in participants with hip osteoarthritis. Hip TVT is usually performed manually by the physiotherapist. OBJECTIVE: A medical device was developed to perform hip-TVT in order to investigate effects on hip disability, pain intensity, recovery of balance and functional mobility in older adults with hip osteoarthritis and also to reduce physiotherapists' workload and help standardize treatment of hip TVT. METHODS: In a block-randomized 3-month controlled trial involving 28 older adult participants with symptomatic primary hip osteoarthritis (SPHOA), one group (n = 10) received device-performed TVT, one (n = 10) manual TVT, and one (n = 8) sham/placebo therapy. Hip disability (Harris Hip Score), pain intensity (visual-analog-scale), recovery of balance and gait (Functional Gait Assessment) and functional mobility (Timed-Up-and-Go-test) were assessed at baseline, after 3 weeks without intervention, and after 3-month intervention. RESULTS: The Device TVT and Manual TVT groups exhibited superior outcomes compared to the Placebo group in terms of hip disability (p = 0.005 and p < 0.001, respectively), pain intensity (p = 0.002 and p < 0.001, respectively), and functional mobility (TUG) (p = 0.012 and p = 0.011, respectively). Furthermore, the recovery of balance and gait (FGA) showed a significant improvement in the Device TVT group when compared to the Placebo group (p = 0.043). The effect sizes ranged from 0.17 to 0.51, indicating moderate to large effects. CONCLUSION: Device-performed-TVT is comparable to manual hip-TVT for reducing pain and improving mobility in older adults with SPHOA, and may be beneficial in terms of reducing physiotherapists' workload and better therapy standardization. [ABSTRACT FROM AUTHOR]

BACKGROUND: Sedentary work may lead to low back pain. In particular, a slumped sitting position may exacerbate low back pain because of tissue damage caused by excessive lumbar flexion and posterior pelvic tilting. Subjects with low back pain may have excessive changes in the lumbopelvic posture and back muscle activity in the sitting position. OBJECTIVE: The purpose of this study was to compare the effects of vibration-based biofeedback using a motion sensor belt and no biofeedback on multifidus (MF) muscle activity and pelvic tilt angle during typing. METHODS: Thirty subjects with low back pain accompanied by hip flexion limitation (15 each in the biofeedback and non-biofeedback groups) were enrolled. Electromyography was used to investigate MF muscle activity before and after typing for 30 min. Pelvic tilt was measured after typing in a sitting position for 30 min. Independent t-tests were used to compare MF muscle activity, and pelvic and second sacrum tilt angles, between the biofeedback and non-biofeedback groups. RESULTS: After typing for 30 min, changes in MF muscle activity (11.45% and - 7.19% for the biofeedback and nonbiofeedback groups, respectively) and pelvic and second sacrum tilt angles (3.15 ∘ and 4.12 ∘ for the biofeedback group and - 11.05 ∘ and - 18.16 ∘ for the non-biofeedback group, respectively) were significantly smaller in the biofeedback than non-biofeedback group (p < 0.05). CONCLUSION: Vibration-based biofeedback minimizes the reduction in MF muscle activity and changes in pelvic and second sacrum tilt angles during typing in individuals with low back pain accompanied by hip flexion limitation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Measurements of hip abduction (ABD) and adduction (ADD) are important in strength and conditioning as well as in clinical practice. However, there is no clear consensus on how ABD and ADD compare in strength in different populations. OBJECTIVE: The aim was to perform a quantitative synthesis of comparisons between the isometric strength of ABD and ADD in different populations. METHODS: ABD and ADD strength data were collected and pooled mean values for ABD:ADD strength ratio were calculated and expressed as standardized mean differences. Forty studies of healthy adults, 5 studies of healthy older adults and 14 studies of adults with various musculoskeletal injuries were included in the analysis. RESULTS: Healthy (non-athletic) males, healthy older adults, and adults with hip and groin pathologies or osteoarthritis tend to have the same ADD and ABD strength; male athletes tend to have a stronger ADD compared with ABD; healthy females and adults with patellofemoral pain tend to have a stronger ABD compared with ADD. CONCLUSIONS: These results can serve as a database to help compare and interpret measurements of ADD and ABD strength ratio in different populations. [ABSTRACT FROM AUTHOR]

Background The use of digital goniometry has emerged as a viable alternative to universal goniometry for assessing hip range of motion (ROM). However, few studies have assessed the use of digital goniometry in pediatric populations and there are a limited number of studies that investigate any one device. The EasyAngle® is a digital goniometer that may be beneficial for use in pediatric settings as it requires only one hand to operate the device. Purpose The purposes of this study were 1) to establish the intrarater and interrater reliability of the EasyAngle® digital goniometer in measuring hip joint ROM in healthy elementary school-aged children, and 2) to establish preliminary normative reference values for each year of age using the EasyAngle® for hip joint ROM in healthy elementary school-aged children. Study Design Descriptive Laboratory Study Methods Passive hip ROM (flexion, abduction, extension, internal rotation, external rotation) was measured on each leg of healthy participants using the EasyAngle®. A total of 40 hip joints were measured. Two blinded raters conducted three trials of each hip motion on both legs. Intrarater and interrater reliability of the recorded hip range of motion were calculated using intra-class correlation coefficients (ICC) (3,1). Results Twenty healthy children were measured (age 5-10, mean = 7.40 years old, SD = 1.37, 9 males, 11 females). Mean hip ROM was reported by age. Intrarater and interrater reliability were good to excellent for all hip ROM measurements (0.81-0.97 intra rater; 0.77-0.91 interrater). Hip flexion had the strongest intrarater (0.96, 0.97) and interrater reliability (0.91). Intrarater reliability was lowest for hip abduction for Rater 1 and hip extension for Rater 2. Interrater reliability was lowest for hip external rotation (0.78) Conclusion The EasyAngle® is a reliable tool for assessing hip range of motion in healthy children ages 5-10. Normative hip ROM values using the EasyAngle® are available to clinicians. Level of Evidence Level 3- Reliability study [ABSTRACT FROM AUTHOR]

Background: Measuring anterior hip coverage on false-profile (FP) radiographs is important for judging anterior hip coverage. Conventionally, the anterior center-edge angle (ACEA) is measured from the anterior edge of the acetabular sourcil (sourcil ACEA); however, the anterior bone edge is also used as the anterior landmark. Purpose: To determine whether the sourcil ACEA or the bone-edge ACEA better represents the anterior coverage of the hip joint. Study design: Descriptive laboratory study. Methods: We retrospectively observed 49 hips in 49 patients who underwent isolated periacetabular osteotomy. The sourcil ACEA was measured according to the standard procedure. Then, 3-dimensional (3D) volumetric models were made from computed tomographic data. The acetabular surface of the 3D model was labeled and projected onto a simulated FP radiograph, enabling the edge of the acetabulum to be identified. This simulated FP radiograph was used to measure the "true ACEA," as well as the sourcil ACEA and the bone-edge ACEA, and the 3 measurements were compared. Statistical analysis was performed-including testing for normal distribution, measuring interobserver agreement, evaluating differences between measurements, and validating correlation. Results: The mean sourcil ACEA was 8.6° (range, -3.9° to 31.7°) smaller than that of the true ACEA (P < .001); there was a strong correlation (r = 0.81; P < .001) between the 2. The mean bone-edge ACEA was 16.8° (range, -1.7° to 45.4°) greater than that of the true ACEA (P < .001); there was a moderate correlation (r = 0.57; P < 0.001) between the 2. Conclusion: Both the sourcil ACEA and bone-edge ACEA differed from the true ACEA. However, compared with the bone-edge ACEA, the sourcil ACEA was numerically closer to the true ACEA and had a stronger correlation with it . Clinical relevance: While the exact edge of the true bearing surface of the articular cartilage may not be visible on the FP radiograph, the sourcil ACEA can be effectively utilized as a reliable surrogate when evaluating the anterior acetabular coverage in hip preservation surgery. [ABSTRACT FROM AUTHOR]

Copyright of Karya Journal of Health Science is the property of Karya Journal of Health Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Hockey players mostly lack flexibility in the hips due to prolonged flexion during competition and overuse of hip extensors and external rotators. The lack of flexibility or dysfunction in the hips can negatively impact the dynamic balance and biomechanics of the lower extremities. Objective: This study aimed to investigate the effect of adding dynamic stretching to the standard warm-ups and static stretching of hip flexors in junior field hockey players' balance, flexibility, and agility. Methods: In this randomized controlled trial, 30 junior field hockey players were randomly assigned into experimental (n = 15) and control groups (n = 15). The control group performed warm-ups, static stretching, and placebo-like stretching exercises. The experimental group performed the same warm-ups, static stretching exercises plus dynamic stretching to hip flexors. The exercise program was performed by alternating between the right and left lower limbs in both groups. The modified Thomas test, Illinois Agility Test, and modified star excursion balance test were used to measure hip muscle flexibility, agility, and dynamic balance after 8 weeks of interventions in both groups. Results: In comparison with the post-test score of both the groups, the experimental group shows a highly statistically significant value in all three measurements of the modified Thomas test (right limb: Cohen's d = 2.1, P < 0.001, left limb: Cohen's d = 1.5, P < 0.001) Illinois Agility Test (Cohen's d = 2.3, P < 0.001) modified star excursion balance test (composite score: right limb Cohen's d = 1.3, P < 0.001, left limb Cohen's d = 1.53, P < 0.001) respectively. Conclusion: The findings of this study revealed that adding dynamic stretching of hip flexors in routine warm-ups and static stretching has significantly increased hip extension range of motion, agility, and dynamic balance in both the right and left limbs among junior field hockey players. [ABSTRACT FROM AUTHOR]

Background: Total hip and knee arthroplasty for end stage arthritis are among the most cost-effective interventions available in all of medicine. Success of hip and knee arthroplasties is not universal and approximately one in ten patients are not satisfied with their arthroplasty and 10 to 34% of patients have an unfavourable long term pain outcome. The aim of this edition of Arthroplasty was to identify factors associated with: (1) poor joint specific outcome, (2) poor health related quality of life outcome and (3) dissatisfaction following total hip and knee arthroplasty. Methods: The scope was deliberately broad to identify factors (known and unknown) that influence outcome of total hip and knee arthroplasty, and of 40 submissions, eight were selected for this special edition after peer review. Results: Many of the included studies reported subjective patient reported outcome measures as their key outcomes but other objective measures such as muscle mass, timed Up-and-Go test, kneeling ability and postoperative pain are also featured. Some studies involved a focus on early rehabilitation after surgery (ERAS) principles and how to optimise pre-rehabilitation and reduce length of hospital stay readmission and reoperation. The effect of metal allergy and drain usage on outcomes is also explored. A variety of methodologies have been used including one randomised control trial, some machine learning and three systematic reviews investigating the effect of metal allergy on outcomes, associations with postoperative pain and the effect of patella resurfacing. Conclusion: This special edition has advanced our knowledge of factors influencing to the outcome of hip and knee arthroplasty but has also identified several areas of research that need to be addressed to improve the outcomes of our patients. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to evaluate comparative biomechanical fixation provided with the BDSF method with the conventional CC screw fixation for treatment of femoral neck fractures with three parallel cannulated screws. Methods: This is a prospective cohort study. There were two teams of surgeons out of which one team operated the patients with BDSF technique and second with conventional CC screw fixation technique; thus, the patients were randomly distributed into two groups. Patients were included in the study as per the following inclusion and exclusion criteria. Results: Union was achieved in 15 (83.33%) patients managed by conventional CC screw technique, while union was achieved in 11 (91.67%) patients managed by BDSF technique in the present study. The average Harris hip score in present study was 90 score in patients managed by BDSF technique, while the average Harris hip score in present study was 80 score in patients managed by BDSF technique. Conclusion: Both BDSF and conventional CC screw fixation are good fixation methods for fracture neck of femur. But functional outcome and fracture union rates are better with BDSF Technique. Although, there are some minor problems noted in BDSF technique such as outer cortical fracture at the entry point of beam screw and opening up of anterior cortex of oblique fracture patterns. Thus, BDSF method provides reliable fixation in which early mobilization and partial weight bearing of the patient may be allowed. [ABSTRACT FROM AUTHOR]

The Beighton Score (BS) is a tool that dichotomizes those who have generalized joint hypermobility (GJH) and those who do not. Unfortunately, the BS is often used in populations that it was not originally developed for, including athletes for screening purposes. The construct validity of the BS remains unknown in this population. This secondary analysis investigated the construct validity of the BS by comparing varsity athletes' passive shoulder and hip ranges of motion (ROMs) to their respective BS and individual forward bend tests (FBTs). There were statistically significant but weak correlations between shoulder ROMs and the BS (r=0.142, p=0.021). Mean hip ROMs were greater by 5-degrees in those with positive FBTs compared to those with negative FBTs. This difference falls within typical measurement errors that occur in practice. Therefore, our results do not support the construct validity of the BS as a measure of GJH in healthy athletes. [ABSTRACT FROM AUTHOR]

Preserving or preventing declines in bone mineral density (BMD) is imperative. As jumping is a high-impact bone-loading action, this meta-analysis evaluated the efficacy of jump training to improve BMD and bone turnover relative to non-jumping controls in men and women > 18 years, following Preferred Reported Items for Systematic Reviews and Meta-Analysis guidelines. PubMed and COCHRANE Library databases were searched until February 2022. Fifteen articles (19 jumping-trials) met the predetermined search criteria. Eighteen trials were included for BMD data (n = 666 participants). There was a significant small-moderate effect of jumping on femoral neck BMD (%mean difference: 95%CI, +1.50%: 0.83%; 2.17%, p < 0.0001), that remained significant after sub-analysis by age for both younger (+1.81%: 0.98%; 2.65%) and older adults (+1.03%: 0.02%; 2.03%). BMD of total hip (+1.26%: 0.56%; 1.96% vs + 0.06%: −0.96%; 1.08%), and trochanter (+0.84%: 0.20%; 1.48% vs −0.16%: −1.08%; 0.76%) increased significantly with jump training only in younger adults and non-significantly at the lumbar spine (+0.84%: −0.02%; 1.7% vs −0.09%: −0.96%; 0.77%) only in younger but not older adults, respectively. The BMD response to jump training appears to be site-specific, with the highest sensitivity at the femoral neck. No dose-response effect suggests moderate certainty of a gain in femoral neck BMD when performing the median jump-load of 50 jumps four times weekly. [ABSTRACT FROM AUTHOR]

Hip and shoulder range of motion (ROM) alterations are correlated with increased risk of injury in softball athletes. The purpose of this study was to investigate bilateral shoulder and hip ROM adaptation during a simulated softball double-header exposure. It was hypothesized that shoulder and hip ROM would decrease after simulated game exposure and would not return to baseline following a 30-minute break. Thirty (14.8±1.9 yrs, 162.5±18.3 cm, 71.79±16.03 kg) adolescent softball pitchers participated. Testing included: bilateral hip and shoulder ROM (preSG), simulated game exposure (100 pitches), bilateral hip and shoulder ROM (postSG), 30-minute break, bilateral hip and shoulder ROM (preDH), pitching first inning of a simulated double header (12 pitches), and bilateral hip and shoulder ROM (postDH). Two separate repeated measures multivariate analyses of variance tests determined differences in ROM between time points. Dominant shoulder internal rotation ROM and non-dominant shoulder internal and external rotation ROM significantly decreased from preDG. Stride hip external rotation ROM and drive hip internal and external rotation ROM significantly decreased from preSG to preDH. Key results revealed the break given between games may not be sufficient recovery time for hip ROM. Thus, assessing ROM as workload progresses can be a useful strategy for monitoring a softball pitcher's injury risk. [ABSTRACT FROM AUTHOR]

The use of technology has increased over the last decade across all surgical specialties. Robotics is the ultimate tool and can accomplish accuracy and consistency for surgeons executing their preoperative plan. In orthopedic surgery, robotic-assisted knee and hip arthroplasty techniques have experienced rapid growth, and the next field of interest is, without a doubt, shoulder arthroplasty. While the survival rates extend to over 90% at 10 years of follow-up and overall satisfaction rates are very high, some report that up to 10% of the patients with a shoulder replacement remain dissatisfied with their postoperative range of motion and overall functional outcome. There have been numerous advances in implant designs and materials as well as the introduction of enhanced recovery programs, however, reported patient outcomes, and reoperation rates may not always have significantly benefited from those advances in shoulder arthroplasty over the last two decades. Lately, the digitalization of shoulder arthroplasty has drawn a lot of attention with the intent to improve the correction of joint deformities and component implantation, possibly leading to enhanced patient outcomes after shoulder arthroplasty. The potential benefits of shoulder robots are multiple. First, by converting data from imaging or intraoperative anatomy mapping, a patient-specific 3-dimensional representation of the joint may facilitate surgical planning and subsequent boundary control for the bony resections, reaming, and implant positioning. Second, the system may allow intraoperative assessment of the range of motion and joint stability. Third, research may be facilitated and encouraged by supporting case-by-case data collection. This next evolution in surgical technology aims to make shoulder replacements accurate and reproducible in both easy and challenging shoulders and usable by both low-volume and highly experienced surgeons. [ABSTRACT FROM AUTHOR]

Obtaining a proper position for total hip arthroplasty components is a crucial aspect of implant performance and consequently of patient outcomes. Restoring the original hip center and maintaining the limb length are key factors in reaching the optimal implant positioning. The aim of this study was to assess the accuracy and safety of a computed dynamic analysis system that, through patient-specific guides, tries to improve implant positioning and functional orientation according to patients' spinopelvic mobility and anatomy. A total of 100 consecutive patients were prospectively enrolled. All patients received an Optimized Positioning System dynamic hip preoperative planning schedule. A CT scan protocol follow-up analysis was performed 6 months after surgery. The mean deviations from the planned acetabular inclination and anteversion were 4.3° and 3.8°, respectively. In total, 98% of cases were within ± 10° of the Lewinnek safe zone, both for inclination and anteversion. The height of osteotomy deviated, on average, 1.6 mm. In total, 100% of cases were included within 4 mm of osteotomy. Patient-specific and laser-guided instrumentation was found to be safe and accurately reproduced dynamic planning in terms of the component orientation, osteotomy level, leg length and offset. [ABSTRACT FROM AUTHOR]

Background: Neuromuscular fatigue can increase the activation of antagonist muscles, thereby reducing the moment produced by the agonist. During the deceleration phase of landing, hip extensor and knee flexor muscles contract eccentrically to counteract the external hip flexion moment. Decreased hip flexion is associated with greater knee extensor moments and risk of injury. Purpose: To investigate sex-based differences in kinematics and muscle activity after neuromuscular fatigue of the hip extensors and knee flexors during dynamic single-leg tasks. Study Design: Controlled laboratory study. Methods: In this study, 9 female (age, 22.3 ± 3.4 years) and 7 male participants (age, 21.3 ± 2.6 years) completed the triple hop (THop) for distance and single-leg drop-jump (SJump) tasks before and after a fatigue protocol consisting of eccentric hip extension and knee flexion. Motion capture and electromyography were used to compare lower extremity kinematics and muscular activation between the sexes. Results: During the THop, neuromuscular fatigue resulted in significantly decreased maximum hip flexion angles (P =.01), maximum knee flexion angles (P =.039), and an effect of sex on all hip flexion angles, where both sexes saw decreased hip flexion postfatigue (P =.033). A significant interaction of fatigue and sex on hip flexion angular velocity was observed during the SJump, indicating that men experienced an increase while women experienced a decrease in hip flexion angular velocities due to fatigue (P =.03). Gluteus maximus activation was increased, and erector spinae activation was decreased postfatigue in women during the THop (P =.053 and P =.023, respectively). Conclusion: Results indicate that men and women compensated differently after fatigue of the hip extensors and knee flexors. Clinical Relevance: Women more commonly assumed an erect landing posture associated with increased injury risk after fatigue of the hip extensors and knee flexors. [ABSTRACT FROM AUTHOR]

Background: Increased posterior tibial slope (PTS) and decreased patellar height (PH) after medial opening wedge high tibial osteotomy (MOWHTO) have been repeatedly reported in the literature. However, this has been disputed in more recent biomechanical studies. Hypothesis: No change in PTS or PH would result after MOWHTO with the freehand technique, regardless of the degree of the coronal plane correction. Study Design: Case series. Methods: A total of 62 patients who underwent MOWHTO between 2018 and 2020 were included. Surgery was performed using a dedicated step-by-step protocol to reduce the risk of unintentional slope changes. All patients were evaluated preoperatively and at a 2-year follow-up with the Knee injury and Osteoarthritis Outcome Score and the University of California, Los Angeles physical activity scale. Pre- and postoperative radiographic lower limb alignment parameters—including hip-knee-ankle angle (HKA), medial proximal tibial angle (MPTA), mechanical lateral distal femoral angle, proximal posterior tibial angle (PPTA), joint line convergence angle, and joint line obliquity—were measured on full-length lower limb radiographs. PH measurements assessed on lateral and anteroposterior knee radiographs included the Caton-Deschamps, Insall-Salvati, and Schröter indices. Results: A significant change was observed in the coronal plane alignment, with an increase in the MPTA from 84.38° to 90.39° (P <.001) and a consequent increase in the HKA from 172.19° to 180.15° (P <.001). No significant changes were observed in the PTS, as evidenced by a postoperative PPTA of 80.6° versus a preoperative value of 80.4° (P =.2). No significant changes were detected in the mean PH on all 3 indices used—pre- versus postoperative Caton-Deschamps, Insall-Salvati, and Schröter indices measured 0.95 versus 0.93 (P =.2), 1.03 versus 1.03 (P =.5), and 1.56 versus 1.54 (P =.3), respectively. Conclusion: In this study, MOWHTO did not result in significant changes in the PTS or PH when accurate preoperative planning and precise intraoperative freehand technique were adopted.. [ABSTRACT FROM AUTHOR]

* OBJECTIVE: To summarize the effectiveness of interventions for changing movement during weight-bearing functional tasks in people with patellofemoral pain (PFP). * DESIGN: Systematic review with network meta-analysis (NMA). * LITERATURE SEARCH: Medline, Embase, CINAHL, SPORTDiscus, and Cochrane Library were searched from inception up to May 2023. * STUDY SELECTION CRITERIA: Randomized controlled trials involving people with PFP and nonsurgical, nonpharmacological interventions on task kinematics were included. * DATA SYNTHESIS: NMA was conducted for frontal knee movement data, and pairwise meta-analysis was used to pool data when NMA was not possible. Reduced movements were those changes that indicated movements occurring with less amplitude. The GRADE approach was used to grade the certainty of the evidence. * RESULTS: Thirty-seven trials were included (n = 1235 participants). Combining knee/hip exercises with internal feedback had the strongest effect on reducing frontal knee movements (standardized mean difference [SMD] from NMA = -2.66; GRADE: moderate evidence). On pairwise comparisons, the same combination of interventions reduced frontal hip movements (SMD = -0.47; GRADE: moderate evidence) and increased sagittal knee movements (SMD = 1.03; GRADE: moderate evidence), with no effects on sagittal hip movements (GRADE: very low evidence), compared to knee/hip exercises alone. There was no effect for single applications of braces on the frontal knee movement (GRADE: very low evidence) and taping on movements of the knee, hip, and ankle (GRADE: very low to low evidence) compared to no intervention. * CONCLUSION: Knee/hip exercises combined with internal feedback techniques may change knee and hip movements in people with PFP. The combination of these interventions can reduce frontal knee and hip movements, and can increase sagittal knee movements. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Early detection of developmental dysplasia of the hip (DDH) in children is crucial. Due to COVID-19, maternal and child health services have been suspended temporarily, increasing the risk of late detection of DDH. This study aimed to reveal Japan's current situation regarding community hip screening for newborns and infants and to provide health guidance for caregivers regarding DDH. A web-based, nationwide cross-sectional survey was conducted between February and March 2023 (n = 1737). One public health nurse overseeing maternal and child health per municipality responded to the 2022 municipality hip screening system. Among the 436 municipalities that responded (response rate: 25.1%), 97.5% implemented hip screening within 4 months, and approximately 60% performed it during newborn home visits, while only 2.3% conducted hip ultrasound screening. Perfect checking of the risk factors for DDH during newborn home visits and training opportunities for home visitors must be improved. Educational programs regarding DDH for home visitors and caregivers are needed to prevent the late diagnosis of DDH. Furthermore, collaboration between pediatric orthopedic surgeons and nurses is crucial for developing effective community-based hip-screening systems by bridging the evidence and practice gap in the early detection of DDH. [ABSTRACT FROM AUTHOR]

Context: Strength deficits of the hamstrings following sports injuries decrease athletic performance and increase the risk of injury recurrence. Previous studies have shown a high correlation between the muscular strength during hip-extension and knee-flexion and total muscle size of the hamstrings. However, it remains unclear which region of the individual hamstring muscles is closely associated with muscular strength. Objective: To investigate the relationship between the size of each region of the individual hamstring muscles and muscular strength during hip extension and knee flexion. Design: Within-subject repeated measures. Setting: University laboratory. Participants: Twenty healthy young male volunteers who regularly engaged in sports activities. Outcome Measures: Anatomical cross-sectional areas were acquired from the proximal, middle, and distal regions of the biceps femoris long head, biceps femoris short head, semitendinosus, and semimembranosus. Hip-extension and knee-flexion strength were measured during maximal voluntary isometric and concentric contractions (angular velocities of 60°/s and 180°/s). Results: The anatomical cross-sectional area of the distal regions in biceps femoris long head (r =.525–.642) and semitendinosus (r =.567) were significantly correlated with hip-extension strength under all conditions and only at an angular velocity of 180°/s, respectively. Meanwhile, anatomical cross-sectional areas of the distal regions in biceps femoris short head (r =.587–.684) and semimembranosus (r =.569–.576) were closely associated with knee-flexion strength under all conditions. Conclusion: These results suggest that muscle size in the distal regions of biceps femoris long head and semitendinosus greatly contributes to the production of hip-extension strength, whereas that of biceps femoris short head and semimembranosus significantly contributes to the generation of knee-flexion strength. These findings could be useful for designing training and rehabilitation programs to efficiently improve strength deficits following sports injuries such as strain injury and anterior cruciate ligament tears. [ABSTRACT FROM AUTHOR]

Differences in walking biomechanics between groups or conditions should be greater than the measurement error to be considered meaningful. Reliability and minimum detectable differences (MDDs) have not been determined for lower-extremity angles and moments during walking within a session, as needed for interpreting differences in cross-sectional studies. Thus, the purpose of this study was to determine within-session reliability and MDDs for peak ankle, knee, and hip angles and moments during walking. Three-dimensional gait analysis was used to record walking at 1.25 m/s (±5%) in 18 men, 18-50 years of age. Peak angles and moments were calculated for 2 sets of 3 trials. Intraclass correlation coefficients (3, 3) were used to determine within-session reliability. In addition, MDDs were calculated. Within-session reliability was good to excellent for all variables. The MDDs ranged from 0.9° to 3.6° for joint angles and 0.06 to 0.15 N·m/kg for joint moments. Within-session reliability for peak ankle, knee, and hip angles and moments was better than the between-session reliability reported previously. Overall, our MDDs were similar or smaller than those previously reported for between-session reliability. The authors recommend using these MDDs to aid in the interpretation of cross-sectional comparisons of lower-extremity biomechanics during walking in healthy men. [ABSTRACT FROM AUTHOR]

Context: The trunk/pelvis is an important link between the upper- and lower-extremities. Therefore, assessing strength of the trunk and hip muscles that control the segments is clinically meaningful. While an isokinetic dynamometer can be used to measure trunk strength, the equipment is expensive and not portable. Objective: To test the reliability of simple trunk and hip strength measures that utilize a bar, straps, and a portable tension dynamometer. Design: Test–retest reliability study. Setting: Biomechanics research laboratory. Patients (or Other Participants): Twenty college-age individuals (10 males/10 females, age = 20.9 [3.7] y) participated. Intervention(s): The participants attended 2 testing sessions, 1 week apart. The participants' trunk-flexion, rotation, and hip abduction strength were measured at each session. Main Outcome Measures: Peak trunk flexion, rotation, and hip abduction forces were normalized to the participant's body weight (BW). In addition, hip-abduction torque was calculated by multiplying the force times the leg length and normalized to BW. The trial data from both sessions were used to calculate the intrasession reliability, and the averages from the 2 sessions were used to calculate the intersession reliability. Intraclass correlation coefficients, SEM, and minimal detectable change were calculated to evaluate reliability of measures. Results: The intrasession intraclass correlation coefficients (SEM) for trunk flexion, rotation, hip abduction, and hip abduction torque were.837 (5.2% BW),.978 (1.3% BW),.955 (1.0% BW), and.969 (5.8 N·m/BW), respectively. The intersession reliability for trunk flexion, rotation, hip abduction, and hip abduction torque were.871 (4.3% BW),.801 (3.8% BW),.894 (1.5% BW), and.968 (5.9 N·m/BW), respectively. Conclusions: The measures of trunk and hip abduction strength are highly repeatable within a session. The reliability of the measures between sessions was also good/excellent with relatively small SEM and minimal detectable change. The tests described in this study can be used to assess changes in trunk/hip strength over time. [ABSTRACT FROM AUTHOR]

Context: Deficits in the hip range of motion are associated with hip and groin injuries. Accurate and reliable goniometric measurements are important in identifying those at risk of injury and determining the efficacy of treatment interventions. Smartphone goniometric applications are regularly used to assess joint ranges of motion; however, there is limited knowledge on the reliability of this method in relation to the hip, particularly between clinicians with different levels of experience. Objective: To determine the intratester and intertester reliability of a smartphone clinometer application for the assessment of hip goniometric measurements in healthy volunteers by an experienced and novice clinician. Design: Reliability study. Setting: University Athletic Therapy facility. Participants: Physically active, university students. Main Outcome Measures: The study determined the intra- and intertester (experienced vs novice clinician) reliability of goniometric measurements of the hip joint (modified Thomas test and seated hip internal and external rotation) using a smartphone goniometric application. Intraclass correlation coefficients (ICCs), standard error of measurement, and minimal detectable change at a 95% confidence interval were used to assess reliability. Results: Goniometric measurements demonstrated good to excellent relative intratester reliability for the modified Thomas test (ICC =.94), external rotation (ICC =.93–.95), and internal rotation (ICC =.80–.81). Intertester reliability for expert and novice clinicians was also excellent for the modified Thomas test (ICC =.98), external rotation (ICC =.95), and internal rotation (ICC =.92). Intratester and intertester standard error of measurement and minimal detectable change at 95% confidence interval values were similar for both testers and ranged from 1.9° to 3.6° and 5° to 10.1° and from 1.1° to 2.3° and 2.9° to 6.5°, respectively. Conclusion: Smartphone-based goniometric measurements of hip range of motion have high intratester and intertester reliability for novice and expert clinicians. It may be a useful, simple, and inexpensive resource for clinicians. [ABSTRACT FROM AUTHOR]

Pelvic drop is caused by decreased hip abductor muscle activity and is associated with lower-extremity injury. Hip abductor strengthening exercises are well established; however, no standard method exists to increase hip abductor activity during functional activities. The purpose of this research was to study the effects of walking with a unilateral weight. A total of 26 healthy adults walked on an instrumented treadmill with and without handheld weight (15%–20% body weight). Muscle activity, kinematic, and kinetic data were collected using surface electromyography, motion capture, and force plates, respectively. Average hip and trunk muscle activity, hip, pelvic, and trunk angles, and peak internal hip moments during stance were compared for each side (contralateral/ipsilateral to the weight) between conditions (unweighted/weighted) using a generalized linear model with generalized estimating equation correction. Interactions between condition and side were observed for muscle activity, frontal plane pelvic and trunk angles, and frontal plane hip moments (P ≤.003). Compared with the unweighted condition, the weighted condition had higher hip abductor activity contralateral to the weight (P <.001), while no change was found ipsilateral to the weight (P ≥.790). Similar changes were found for kinematic and kinetic variables. Walking with a unilateral weight may be a therapeutic option to increase functional hip abductor activity. [ABSTRACT FROM AUTHOR]

Context: Side bridge exercises strengthen the hip, trunk, and abdominal muscles and challenge the trunk muscles without the high lumbar compression associated with trunk extension or curls. Previous research using electromyography (EMG) reports that performance of the side bridge exercise highly activates the gluteus medius (Gmed). However, to the best of our knowledge, no previous research has investigated EMG amplitude in the hip and trunk muscles during side bridge exercise in subjects with Gmed weakness. Objective: The purpose of this study was to examine the EMG activity of the hip and trunk muscles during 3 variations of the side bridge exercise (side bridge, side bridge with knee flexion, and side bridge with knee flexion and hip abduction of the top leg) in subjects with Gmed weakness. Design: Repeated-measures experimental design. Setting: Research laboratory. Patients: Thirty subjects (15 females and 15 males) with Gmed weakness participated in this study. Intervention: Each subject performed 3 variations of the side bridge exercise in random order. Main Outcome Measures: Surface EMG was used to measure the muscle activities of the rectus abdominis, external oblique, longissimus thoracis, multifidus, Gmed, gluteus maximus, and tensor fasciae latae (TFL), and Gmed/TFL muscle activity ratio during 3 variations of the side bridge exercise. Results: There were significant differences in Gmed (F2,56 = 110.054, P <.001), gluteus maximus (F2,56 = 36.416, P <.001), and TFL (F2,56 = 108.342, P <.001) muscles among the 3 side bridge exercises. There were significant differences in the Gmed/TFL muscle ratio (F2,56 = 20.738, P <.001). Conclusion: Among 3 side bridge exercises, the side bridge with knee flexion may be effective for the individuals with Gmed weakness among 3 side bridge exercises to strengthen the gluteal muscles, considering the difficulty of the exercise and relative contribution of Gmed and TFL. [ABSTRACT FROM AUTHOR]

Purpose: Concentric hip and eccentric knee joint mechanics affect sprint performance. Although the biarticular hamstrings combine these capacities, empirical links between swing phase mechanics and corresponding isokinetic outcome parameters are deficient. This explorative study aimed (1) to explain the variance of sprint velocity, (2) to compare maximal sprints with isokinetic tests, (3) to associate swing phase mechanics with isokinetic parameters, and (4) to quantify the relation between knee and hip joint swing phase mechanics. Methods: A total of 22 sprinters (age = 22 y, height = 1.81 m, weight = 77 kg) performed sprints and eccentric knee flexor and concentric knee extensor tests. All exercises were captured by 10 (sprints) and 4 (isokinetics) cameras. Lower-limb muscle balance was assessed by the dynamic control ratio at the equilibrium point. Results: The sprint velocity (9.79 [0.49] m/s) was best predicted by the maximal knee extension velocity, hip mean power (both swing phase parameters), and isokinetic peak moment of concentric quadriceps exercise (R2 = 60%). The moment of the dynamic control ratio at the equilibrium point (R2 = 39%) was the isokinetic parameter with the highest predictive power itself. Knee and hip joint mechanics affected each other during sprinting. They were significantly associated with isokinetic parameters of eccentric hamstring tests, as well as moments and angles of the dynamic control ratio at the equilibrium point, but restrictedly with concentric quadriceps exercise. The maximal sprints imposed considerably higher loads than isokinetic tests (eg, 13-fold eccentric knee joint peak power). Conclusions: Fast sprinters demonstrated distinctive knee and hip mechanics in the late swing phase, as well as strong eccentric hamstrings, with a clear association to the musculoarticular requirements of the swing phase in sprinting. The transferability of isokinetic knee strength data to sprinting is limited inter alia due to different hip joint configurations. However, isokinetic tests quantify specific sprint-related muscular prerequisites and constitute a useful diagnostic tool due to their predicting value to sprint performance. [ABSTRACT FROM AUTHOR]

Although the dynamics of center of mass can be accounted for by a spring-mass model during hopping, less is known about how each leg joint (ie, hip, knee, and ankle) contributes to center of mass dynamics. This work investigated the function of individual leg joints when hopping unilaterally and vertically at 4 frequencies (ie, 1.6, 2.0, 2.4, and 2.8 Hz). The hypotheses are (1) all leg joints maintain the function as torsional springs and increase their stiffness when hopping faster and (2) leg joints are controlled to maintain the mechanical load in the joints or vertical peak accelerations at different body locations when hopping at different frequencies. Results showed that all leg joints behaved as torsional springs during low-frequency hopping (ie, 1.6 Hz). As hopping frequency increased, leg joints changed their functions differently; that is, the hip and knee shifted to strut, and the ankle remained as spring. When hopping fast, the body's total mechanical energy decreased, and the ankle increased the amount of energy storage and return from 50% to 62%. Leg joints did not maintain a constant load at the joints or vertical peak accelerations at different body locations when hopping at different frequencies. [ABSTRACT FROM AUTHOR]

Background: Total hip arthroplasty (THA) performed using the direct anterior approach (DAA) has demonstrated favourable early-, mid-, and long-term outcomes. However, the traditional femoral release technique remains technically demanding and is associated with challenges and a heightened risk of complications. This study aimed to compare the clinical outcomes of patients who underwent THA with DAA performed using either the femoral-release-first (FRF) or the traditional approach (TA) strategy. Methods: A retrospective analysis of demographics, clinical and radiological outcomes, and occurrence of complications was performed using data from 106 patients between 2018 and 2019. The patients were categorised into two groups: FRF (44 hips) and TA (69 hips). Results: The FRF group showed a reduced operative time, haemoglobin (Hb) drop, postoperative hospital stay, and more optimal acetabular cup anteversion angles. Furthermore, during the first 2 months postoperatively, the FRF group demonstrated superior visual analogue scale, Harris Hip, and Oxford Hip scores. In the TA group, two hips experienced greater trochanter fractures, and one experienced delayed incision healing. Conclusions: Compared with the TA, employing the FRF strategy during THA with DAA resulted in improved outcomes within the first 2 months postoperatively and comparable functional recovery beyond this period. The FRF method exhibited advantages such as favourable acetabular exposure and alignment and a reduced risk of complications. Therefore, the FRF strategy may be a favourable option. [ABSTRACT FROM AUTHOR]

Objectives Ectopic calcification (calcinosis) is a common complication of SSc, but a subset of SSc patients has a heavy burden of calcinosis. We examined whether there are unique risk factors for a heavy burden of calcinosis, as compared with a light burden or no calcinosis. Methods We reviewed the medical records of all patients in the Johns Hopkins Scleroderma Center Research Registry with calcinosis to quantify calcinosis burden using pre-specified definitions. We performed latent class analysis to identify SSc phenotypic classes. We used multinomial logistic regression to determine whether latent phenotypic classes and autoantibodies were independent risk factors for calcinosis burden. Results Of all patients, 29.4% (997/3388) had calcinosis, and 13.5% (130/963) of those with calcinosis had a heavy burden. The latent phenotypic class with predominantly diffuse skin disease and higher disease severity (characterized by pulmonary hypertension, interstitial lung disease, cardiomyopathy, severe RP, gastrointestinal involvement, renal crisis, myopathy and/or tendon friction rubs) was associated with an increased risk of both a heavy burden [odds ratio (OR) 6.92, 95% CI 3.66, 13.08; P  < 0.001] and a light burden (OR 2.88, 95% CI 2.11, 3.95; P  < 0.001) of calcinosis compared with the phenotypic class with predominantly limited skin disease. Autoantibodies to PM/Scl were strongly associated with a heavy burden of calcinosis (OR 17.31, 95% CI 7.72, 38.81; P  < 0.001) and to a lesser degree a light burden of calcinosis (OR 3.59, 95% CI 1.84, 7.00; P  < 0.001). Conclusions Calcinosis burden is associated with cumulative SSc-related tissue damage. Independent of disease severity, autoantibodies to PM/Scl are also associated with a heavy burden of calcinosis. [ABSTRACT FROM AUTHOR]

Background: Total hip arthroplasty (THA) is an orthopaedic procedure that improves the quality of life in patients suffering from hip pain related to osteoarthritis, fractures, and avascular osteonecrosis of the femoral head. Different surgical approaches can be used for THA leading to different recovery times. Because of the lowering medium age of people undergoing THA, it is important to focus on the earlier return of physiological activity after surgery. Aim: To evaluate the best approach for THA in terms of earlier return to activity. Method: Studies comparing the postoperative outcomes in patients who underwent THA through different approaches were analysed focusing on patients' self-reported outcomes, ADL score and UCLA activity score with a short follow-up. Results: A total of 1990 articles were identified in the search, and 14 met the inclusion criteria. The Review Manager software version 5.4 was used to conduct a meta-analysis to compare the direct anterior (DAA) and posterior (PA) approaches, which are the most adopted approaches. An earlier return to walk without aids and to independent ADLs were reported with DAA, but without statistical significance (respectively p = 0.06 and p = 0.10). The time to return to drive was similar among the 2 groups (p = 0.88). The return to work was faster with PA, but no statistical significance was reported (p = 0.47). Conclusions: Further studies are needed with a larger number of patients, that present homogeneous outcomes, follow-ups and rehabilitation programmes, and that compare similar surgical approaches to assess the early return to activity of daily living after THA. [ABSTRACT FROM AUTHOR]

Background: Previous studies have demonstrated alterations in squat kinematics in patients with femoroacetabular impingement syndrome (FAIS). Little is known about the effects of arthroscopic hip surgery on biomechanics during a single-leg squat (SLS) in these patients. Purpose/Hypothesis: The purpose of this study was to determine if (1) lower extremity dynamic range of motion (ROM) during an SLS task improves after hip arthroscopy for FAIS and (2) correlations exist between changes in patient-reported outcomes (PROs) and changes in lower extremity dynamic ROM during an SLS after hip arthroscopy for FAIS. It was hypothesized that dynamic hip ROM would improve after hip arthroscopy and that hip dynamic ROM would be associated with changes in PRO scores at both 6 months and 1 year. Study Design: Descriptive laboratory study. Methods: Patients with FAIS performed 3 SLSs that were analyzed using a 20-camera motion capture system. Dynamic ROMs were calculated in 3 planes for the hip, knee, ankle, and pelvic segments. Squat depth was calculated as the change in vertical center of mass during the squat cycle. PROs including the Hip Outcome Score–Activities of Daily Living (HOS-ADL), Hip Outcome Score–Sports (HOS–Sports), International Hip Outcome Tool–12, and visual analog scale for pain scores were collected preoperatively and at the time of postoperative testing. Paired-samples t tests were used to compare kinematic variables pre- and postoperatively. Correlations were used to compare changes in PROs with changes in kinematics. All statistical analysis was performed using SPSS Version 26. Results: Fifteen patients were tested preoperatively and at a mean of 9 months postoperatively. All PRO measures improved postoperatively at 6 months and 1 year. Squat depth and sagittal plane hip and knee dynamic ROMs were significantly improved postoperatively. Positive correlations existed between changes in (1) hip ROM with the 6-month HOS-ADL score (r = 0.665) and (2) knee ROM with the 6 month (r = 0.590) and 1-year (r = 0.565) HOS–Sports scores. Conclusion: Dynamic sagittal plane hip and knee ROMs improve after hip arthroscopy for FAIS. These improvements demonstrate strong correlations with improvements in some but not all postoperative PROs. Clinical Relevance: The current study sought to better understand the role of dynamic movement in the diagnosis and treatment of FAIS. These findings indicate that dynamic ROM and squat depth can, similarly to PROs, serve as biomarkers for patient function both before and after hip arthroscopic surgery. [ABSTRACT FROM AUTHOR]

Background: Young baseball players with medial elbow injuries are known to have high forearm flexor-pronator muscle elasticity; however, the causal relationship between forearm muscle elasticity and the occurrence of medial elbow injuries remains unclear. Purpose/Hypothesis: The purpose of this study was to determine whether the forearm flexor-pronator muscle elasticity is a risk factor for medial elbow injury in young baseball players. It was hypothesized that high flexor carpi ulnaris (FCU) elasticity would be a risk factor for medial elbow injuries. Study Design: Cohort study; Level of evidence, 2. Methods: Young baseball players (aged 9-12 years) with no history of elbow injuries underwent examination during which the strain ratios (SRs) of the pronator teres, flexor digitorum superficialis, and FCU muscles were measured using ultrasound strain elastography as an index of elasticity. Additionally, the participants completed a questionnaire assessing age, height, weight, months of experience as a baseball player, position in baseball, number of training days per week, number of throws per day, and elbow pain during throwing; then the range of motion of the shoulder and hip internal/external rotation were measured. One year after the baseline measurements, the occurrence of new medial elbow injuries was evaluated. Multivariate logistic regression analysis was subsequently conducted to determine risk factors for medial elbow injuries. Cutoff points for significant SR values obtained from the multivariate logistic regression analysis were calculated using the receiver operating characteristic curve. Results: Of the 314 players, 76 (24.2%) were diagnosed with medial elbow injury. Multivariate logistic regression analysis showed that a 0.1 increase in the SR of the FCU muscle (odds ratio [OR], 1.211; 95% CI, 1.116-1.314) and number of throws per day (OR, 1.012; 95% CI, 1.001-1.022) were significantly associated with medial elbow injuries. Receiver operating characteristic curve analyses revealed that the optimal cutoff for the SR of the FCU muscle was 0.920 (area under the curve, 0.694; sensitivity, 75.0%; specificity, 56.7%). Conclusion: Increased FCU elasticity is a risk factor for medial elbow injury. Evaluation of the FCU elasticity may be useful in identifying young baseball players at high risk of medial elbow injuries and may facilitate prevention of medial elbow injury. As shown by the results of multivariate logistic regression analysis, FCU elasticity itself may be useful in identifying young baseball players at high risk of elbow injuries. However, we believe that other factors, such as the number of pitches per day, need to be considered to improve its accuracy. [ABSTRACT FROM AUTHOR]

Individuals with chronic ankle instability (CAI) exhibit altered movement strategies during side-cutting tasks. However, no researchers have assessed how altered movement strategies affect cutting performance. To investigate compensatory strategies in the side-hop test (SHT), with a focus on the entire lower extremity, among individuals with CAI. Cross-sectional study. Laboratory. A total of 40 male soccer players comprising a CAI group (n = 20; age = 20.35 ± 1.15 years, height = 173.95 ± 6.07 cm, mass = 68.09 ± 6.73 kg) and a control group (n = 20; age = 20.45 ± 1.50 years, height = 172.39 ± 4.39 cm, mass = 67.16 ± 4.87 kg). Participants performed 3 successful SHT trials. We calculated SHT time, torque, and torque power in the ankle, knee, and hip joints during the SHT using motion-capture cameras and force plates. Confidence intervals for each group that did not overlap by >3 points consecutively in the time series data indicated a difference between groups. Compared with the control group, the CAI group showed (1) no delayed SHT time; (2) lower ankle-inversion torque (range = 0.11–0.13 N·m/kg) and higher hip-extension (range = 0.18–0.72 N·m/kg) and -abduction torque (0.26 N·m/kg); (3) less concentric power in ankle dorsiflexion-plantar flexion (0.18 W/kg) and inversion-eversion (0.40 W/kg), more concentric power in hip flexion-extension (0.73 W/kg), and more eccentric power in knee varus-valgus (0.27 W/kg). Individuals with CAI were likely to rely on hip-joint function to compensate for ankle instability and demonstrated no differences in SHT time compared with the control group. Therefore, the movement strategies of individuals with CAI could differ from those of individuals without CAI, even if SHT time is not different. [ABSTRACT FROM AUTHOR]

Participants with chronic ankle instability (CAI) frequently display altered movement patterns during functional movements. However, it remains unclear how these altered joint kinematics during jump landing negatively affect ankle joint health in the CAI population. Calculating joint energetics may offer an important method to estimate the magnitude of lower extremity joint loading during functional movements in participants with CAI. To determine differences in energy dissipation and generation by the lower extremity during maximal jump landing and cutting among groups with CAI, copers, and controls. Cross-sectional study. Laboratory. Forty-four participants with CAI, 44 copers, and 44 controls. Kinematics and kinetics of the lower extremity and ground reaction force data were collected during a maximal jump-landing and cutting task. The product of angular velocity in the sagittal plane and joint moment data represented joint power. Energy dissipation and generation by the ankle, knee, and hip joints were calculated by integrating regions of the joint power curve. Participants with CAI displayed reduced ankle energy dissipation (35.9% ± 10.1%) and generation (31.6% ± 12.8%; P <.01) compared with copers (dissipation = 43.6% ± 11.1%; generation = 40.4% ± 12.0%) and controls (dissipation = 41.3% ± 11.1%; generation = 39.6% ± 12.0%) during maximal jump landing and cutting. Participants with CAI also displayed greater energy dissipation at the knee (45.1% ± 9.1%) than copers (39.7% ± 9.5%) during the loading phase and greater energy generation at the hip than controls (36.6% ± 16.8% versus 28.3% ± 12.8%) during the cutting phase. However, copers displayed no differences in joint energetics compared with controls. Participants with CAI displayed differences in both energy dissipation and generation by the lower extremity during maximal jump landing and cutting. However, copers did not show altered joint energetics, which may represent a coping mechanism to avoid further injuries. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the efficacy and safety of combined methylprednisolone (MP) and tranexamic acid (TXA) in promoting accelerated rehabilitation following total hip arthroplasty (THA). We further investigated effective strategies for rapid rehabilitation post-THA. Methods: Conducted as a randomized controlled trial involving 80 patients, the study allocated subjects into two groups. The control group received saline and TXA, whereas the experimental group was administered with an additional dose of MP. Several clinical parameters, including markers of inflammation, pain, nausea, and coagulation factors, were meticulously assessed in both groups. Results: It was observed that the group receiving the MP + TXA treatment showcased significant reductions in postoperative levels of CRP and IL-6, as well as an alleviation in pain scores. Furthermore, this group demonstrated lower incidences of postoperative nausea and fatigue, facilitating enhanced hip joint mobility. Interestingly, this group did exhibit blood glucose fluctuations within the first 24 h postoperatively. However, there was no notable difference between the groups concerning transfusion rate, postoperative hospital stay duration, and coagulation profile, and no severe complications were reported. Conclusion: The findings suggest that the combined administration of MP and TXA can appreciably enhance postoperative recovery, by reducing inflammatory markers, alleviating pain, reducing nausea and fatigue, and improving hip mobility, without leading to an increased risk of severe perioperative complications. This highlights the potential role of this combined therapy in facilitating improved postoperative patient experiences. [ABSTRACT FROM AUTHOR]

The work investigates the relationship between the leg spread and hip joint flexibility during kicking action of highly skilled martial artists. Vector-based spreading angles (VSAs), as a simplified way to assess kick execution patterns and movement ranges, are proposed. The first VSA measures the angle between the two femur vectors (i.e., upper leg spread), whereas the second describes the full-leg spread. The proposed measures were applied to 3D motion analysis performed on 33 participants at various skill levels who executed double side kicks and performed two static flexibility tests (hip joint flexion and abduction). Statistical analysis showed that the proposed parameters differentiate between skill levels. Both VSAs and VSA rate of change showed high Pearson correlation to the quality of execution (the average of 10 subjective kickboxing experts' evaluation scores) at critical instants of the kick execution , i.e., during the first leg elevation and kick (angles: ρ > 0.8; p < 0.001). In addition, they significantly correlated to maximum static hip abduction at any instant (ρ = 0.37–0.69; p < 0.05). The work established that both static and dynamic joint flexibility contribute to high-performance levels and could be used for initial selection and assessment of training effectiveness. [ABSTRACT FROM AUTHOR]

Femoroacetabular impingement (FAI) in ice hockey is a concern for many athletes. The biomechanics of skating and the injury mechanism, prevalence, identification, and treatment protocols currently available for FAI in ice hockey athletes are important for all coaches and practitioners to understand. This article discusses the underlying anatomical issues and biomechanical considerations surrounding FAI. Furthermore, this article describes the interventions that can be used when encountering FAI and well-established protocols to aid in the return to play. Finally, prevention strategies that can aid in injury prevention are discussed. [ABSTRACT FROM AUTHOR]

Background: Sports function and psychological readiness to return to sports (RTS) are important outcomes when evaluating rehabilitation after anterior cruciate ligament reconstruction (ACLR). It is, however, unclear which specific factors contribute most to these outcomes. Purpose: To determine associations between demographic characteristics, objective measurements of physical function, patient-reported outcome measure scores, sports-related function assessed with the Knee injury and Osteoarthritis Outcome Score (KOOS) Sport and Recreation subscale, and psychological readiness to RTS assessed with the Anterior Cruciate Ligament–Return to Sport after Injury (ACL-RSI) scale at 1 year after ACLR. Study Design: Cross-sectional study; Level of evidence, 3. Methods: At a mean of 12.5 ± 2.0 months after ACLR, 143 participants (50.3% female), with a mean age of 25.0 ± 5.7 years, were assessed for demographic characteristics, physical factors (hop performance, muscle strength, ankle and hip range of motion), and psychological factors (KOOS Pain and Symptoms subscales, Perceived Stress Scale, fear of reinjury) as well as the KOOS Sport and Recreation subscale and ACL-RSI scale. Backward linear regression models were used to evaluate factors associated with sports function and psychological readiness to RTS. Results: Lower isokinetic knee extension peak torque (limb symmetry index) (B = 18.38 [95% CI, 3.01-33.75]), lower preinjury activity level (B = 2.00 [95% CI, 0.87-3.14]), greater knee pain (B = 0.90 [95% CI, 0.70-1.10]), shorter time between injury and reconstruction (B = 0.16 [95% CI, 0.05-0.26]), and greater fear of reinjury (B = 0.11 [95% CI, 0.01-0.20]) were associated with a worse KOOS Sport and Recreation subscore (R 2 = 0.683). A shorter hop distance (B = 0.15 [95% CI, 0.00-0.29]) was associated with a lower ACL-RSI score (R 2 = 0.245). Conclusion: A combination of knee muscle strength, activity level, knee pain, timing of surgery, and fear of reinjury accounted for approximately 70% of the variation in sports function at 1 year after ACLR. In contrast, there was only 1 weak association between physical function and psychological readiness to RTS at this time point. Thus, factors associated with current sports function are much better known than features related to psychological readiness to RTS. [ABSTRACT FROM AUTHOR]

Objective. To compare the activation of the gluteus medius (GM) and tensor fasciae latae (TFL) muscles, during eleven exercises to strengthen the lateral hip region in volunteers with and without pattelofemoral pain. Methods. Twenty-four females participated in this study, the evaluation was performed through the electromyography analysis of the GM and TFL muscles during exercise, and strength was evaluated through of the contraction isometric volunteers' maximum to the normalization of data of the electromyography. Results. The exercises: Clam, squatting, single-limb squat, single-limb deadlift, the lateral plank, the hip abduction in orthostatims, sinking exercise, trunk lateral rotation, unilateral bridge, double-leg-kick and lateral elevation. These exercises were used as task to all volunteers. Demonstrated that most asymptomatic patients had greater activation in the GM, while the symptomatic group obtained greater activation values in TFL. In most exercises, the activation of the GM was earlier (p < 0.05). Conclusions. The symptomatic group showed greater activation in the TFL. While the asymptomatic group presented greater activation in the GM in most exercises. [ABSTRACT FROM AUTHOR]

There is growing interest in the role of social support during the recovery after hip fractures. The research to date has been mainly focused on structural support, with few studies concerned with functional support. This study examined the effects of both functional and structural aspects of social support on rehabilitation outcomes among older adults with hip fracture surgery. Prospective cohort study. Consecutive older adults (≥60 years) with hip fracture surgery who underwent inpatient rehabilitation in a post-acute care facility in Singapore between January 11, 2021, and October 30, 2021 (n = 112). We administered the Medical Outcome Study–Social Support Survey (MOS-SSS) to assess perceived functional support of patients and used living arrangement as an indicator for structural support. Participants were followed up over the inpatient stay at the post-acute care facility until discharge; thereafter, rehabilitation efficiency (REy) and rehabilitation effectiveness (REs) were evaluated. Multiple linear regressions were performed to examine the associations of MOS-SSS score and living arrangement with REy and REs, respectively, adjusting for age, gender, ethnicity, comorbidity, body mass index, prefracture function, type of fracture, and length of stay. Perceived functional support had positive associations with rehabilitation outcomes. A 1-unit increase in MOS-SSS total score was associated with 0.15 units (95% CI 0.03–0.3, P =.029) greater gain in physical function after a typical 1-month stay, and 0.21 units (95% CI 0.01–0.41, P =.040) higher achievement in potential functional improvement upon discharge. In contrast, no association was observed between structural support and rehabilitation outcomes. Perceived functional support may significantly impact the recovery of older adults with hip fracture during the inpatient rehabilitation process, independent of structural support. Our findings suggest the potential of incorporating interventions enhancing perceived functional support of patients into the post-acute care model for hip fracture. [ABSTRACT FROM AUTHOR]

BACKGROUND: Prolonged sitting during work is common and has been shown to cause health issues. However, changing working postures has been reported to reduce musculoskeletal issues and impact other health issues; thus, there is a need for an office environment with multiple choices of working postures. OBJECTIVE: The purpose of this study was to evaluate changes in body position, body loading, and blood perfusion while in a seated, standing, and new office seating position, termed the in-between position. METHODS: Ground reaction forces, joint angles, pelvic tilt, openness angle (angle between the pelvis plane and thorax), and blood perfusion were evaluated for three positions. A motion capture system with markers was used to capture the position of anatomical landmarks. A six-axis force plate was used to collect the ground reaction forces, and a laser doppler perfusion monitor was used to obtain the blood perfusion. RESULTS: Data showed that the in-between position articulated the hips, which provided a hip and lumbar position closer to a standing posture than a seated posture. The average vertical ground reaction force in the in-between position was larger than the seated position but significantly smaller than during standing (p < 0.0001). There were no significant differences in anterior/posterior ground reaction forces between the seated and the in-between positions (p = 0.4934). Lastly, blood perfusion increased during the dynamic transitions between positions indicating changes in blood flow. CONCLUSION: The in-between position provides benefits of both standing (larger pelvic tilt and increased lumbar lordosis) and sitting (reduction in ground reaction forces). [ABSTRACT FROM AUTHOR]

An accurate and reliable neurological examination is pivotal in diagnosing patients with neurological and neurosurgical conditions. Despite the advancement of neuroscientific knowledge and the ever-progressing technologies and modalities that are being adopted to help achieve the challenge of accurate diagnosis, the neurologic examination is still crucial in both ambulatory and emergency settings. It provides the physician a tool to recognise neurologic involvement in certain disease states, and thereby allow proper work-up and treatment for patients. A basic neurologic examination can be performed rapidly with practice. Manual muscle testing of the lower limbs was carried out in accordance with a bedside clinical examination involving a clinical personnel examiner and a patient. This testing was performed in a rostro-caudal manner, starting from the hip and progressing to the toes. The neurological exam can be intimidating to perform for a lot of physicians. Deficiencies in accurate muscle testing have always presented a challenge for medical students and clinicians. By referring to the examination methods mentioned in our text and with the help of related video, it is our aim to improve the quality of neurological examination among medical personnel so that diseases may be recognised and managed earlier in their course. [ABSTRACT FROM AUTHOR]

Aiming to determine the association between joint range of motion (ROM) and muscle strength; and, the effect of age and menarche on those two factors; 132 pre-and post-menarche dancers, aged 12–14 years were assessed for joint ROM and for muscle strength at the hip, knee and ankle and foot joints. En-pointe ROM was significantly correlated with ankle plantar-flexors' (r = −.184) and with ankle dorsiflexors' muscle strength (r = −.221). Hip external rotation ROM was significantly correlated with knee extensors' strength (r = −.263). Pre-menarche dancers had higher joint ROM compared with post-menarche dancers; yet, dancers at post-menarche were stronger compared to dancers at pre-menarche. The slope coefficient was negative at the age of 12 in hip external rotation and in en-pointe (−0.80 and −0.52, respectively) and became steeper with age (age 13: −3.52 and −3.28, respectively; age 14: −6.31 and −4.42, respectively). Along maturation, dancers with high joints ROM showed reduced muscle strength. Pre-menarche dancers have higher joint ROM, yet reduced muscle strength, compared with post-menarche dancers. As the association between joint ROM and muscle strength might be involved with growth and development, young dancers should be screened along pubertal stages in order to decide the correct curricula and to prevent future injuries. [ABSTRACT FROM AUTHOR]

Background: Acetabular bone loss is a challenging problem for revision hip surgeons. This study aimed to explore long-term outcomes of patients who have undergone cemented acetabular revision in conjunction with trabecular metal augmentation and impaction bone grafting in cases with significant segmental bone loss. Methods: All patients who underwent cemented acetabular revision requiring impaction bone grafting and trabecular metal augments with a minimum Paprosky score of 2B and minimum follow up of 5 years were identified. Pre- and postoperative WOMAC scores were compared. An assessment of pre- and postoperative hip centre of rotation was performed and compared to native centre of rotation. Immediate postoperative centre of rotation was then compared to radiographs at latest follow up to measure for migration of acetabular components. Results: 42 patients were identified. Mean age was 53 years old with 7 males and 35 female patients. Mean follow-up was 9.5 years. Preoperative WOMAC score was 30 and there was an increase to 90 (p < 0.01) at latest follow-up. No hips were revised for loosening or infection. There was a mean improvement in centre of rotation of 6.80 mm (CI, 4.57–9.03 mm) which was significant (p < 0.00002). There was no change of position of centre of rotation from immediate postoperative radiographs and those at latest follow up (p = 0.3). Conclusions: Cemented acetabular components work well in conjunction with trabecular metal augments and impacted bone grafts in reconstructing complex acetabular defects. Together they provide immediate and long-term component stability, with excellent long-term clinical and radiological outcomes. [ABSTRACT FROM AUTHOR]

Military personnel experience elevated bone injury incidence, partly due to arduous and repetitive training. Non-traditional High-Intensity Interval Training-style (HIIT) may benefit pre-enlisted Reserve Officer Training Corps (ROTC) cadet's musculoskeletal health and performance prior to military service. This study investigated 16 ROTC (n = 12 males; n = 4 females) and 15 physically active sex-, age-, and body mass-matched Controls' musculoskeletal health and performance from November to April. Total body, lumbar spine, and dual- hip dual-energy X-ray absorptiometry scans and 4%, 38%, 66% tibial peripheral quantitative computed tomography scans, blood draws (serum sclerostin and parathyroid hormone), and maximal muscle strength and aerobic capacity testing were completed. From November to April, ROTC improved bone density (DXA) of the dominant total hip and greater trochanter and non-dominant greater trochanter and 38% and 66% tibial total volumetric and cortical bone density (pQCT) similarly or more than Controls (all p ≤ 0.049). From November to April, ROTC also improved bench and leg press, and peak aerobic capacity (all p ≤ 0.013). From November to January, serum sclerostin increased (p ≤ 0.007) and remained elevated through April, while parathyroid hormone was unchanged. HIIT-style training induced positive musculoskeletal adaptations, suggesting it may be an excellent pre-service training modality for this injury prone group. [ABSTRACT FROM AUTHOR]

Golf participation has increased dramatically in the last several years. With this increase in participation, clinicians need better evidenced based strategies to advise those golfers with different pathologies when it is safe to return to the game. Golf teaching professionals also need to understand how to alter golf mechanics to protect injured and/or diseased joints in golfers to allow them to play pain free and avoid further injury. This study used a 3- dimensional link segment model to calculate the net joint moments on the large lower limb joints (knee and hip) during golf (lead and trail leg) and two commonly studied activities of daily living (gait and sit-to-stand) in 22 males, healthy, adult golfers. It also examined the correlations between these knee and hip joint loads and club head speed. The external valgus knee moment and the internal hip adduction moment were greater in the lead leg in golf than in the other activities and were also correlated with club head speed. This indicates a strategy of using the frontal plane GRF moment during the swing. The internal hip extension and knee flexion moment were also greater in the golf swing as compared with the other activities and the hip extension moment was also correlated with club head speed. This emphasizes the importance of hip extensor (i.e., gluteus maximus and hamstring) muscle function in golfers, especially in those emphasizing the use of anterior-posterior ground reaction forces (i.e., the pivoting moment). The golf swing places some loads on the knee and the hip that are much different than the loads during gait and sit-tost-and tasks. Knowledge of these golf swing loads can help both the clinician and golf professional provide better evidence-based advice to golfers in order to keep them healthy and avoid future pain/injury. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pelvic-drop exercise (PD) is unilateral weight-bearing exercise that is frequently performed in rehabilitation sessions because its easy application can trigger moderate-to-high gluteus medius (Gmed) activity. Hip rotation has been applied to effectively facilitate Gmed activity during exercise. OBJECTIVE: To determine the effects of PD with three different hip rotations on Gmed, tensor fasciae latae (TFL), gluteus maximus (Gmax) activity, and Gmed:TFL activity ratio in patients with Gmed weakness. METHODS: Eighteen subjects with Gmed weakness participated. Subjects performed three different forms of PD with neutral hip, hip internal rotation, and hip external rotation position. Surface electromyography was performed to quantify the activity of Gmed, TFL, and Gmax. RESULTS: PD with hip internal rotation showed significantly greater Gmed activity than with neutral hip and hip external rotation (P = 0.005 and P = 0.007, respectively). TFL also showed significantly greater activity during PD with hip interna rotation than neutral hip (P = 0.002). There were no significant differences in Gmax activity (P = 0.095) and Gmed:TFL activity ratio (P = 0.254) among different forms of PD. CONCLUSIONS: PD with hip internal rotation is recommended to stimulate greater Gmed activity while preserving Gmed:TFL muscle activity ratio. [ABSTRACT FROM AUTHOR]

Background Lower neurocognitive function is a risk factor for anterior cruciate ligament (ACL) injury. However, the mechanism by which lower neurocognitive function increases the risk of ACL injury remains unclear. Purpose To clarify the effect of differences in neurocognitive function on landing mechanics during a single-leg drop-jump landing motion followed by an unanticipated task. Study Design Cross-sectional study Methods Fifteen collegiate female athletes were recruited (20.1 ± 1.3 years, 166.6 ± 7.3 cm, 60.6 ± 6.9 kg) and were divided into two groups (the high-performance (HP) group and the lower-performance (LP) group) using the median Symbol Digit Modalities Test (SDMT) score. Three-dimensional motion analysis was employed for the analysis during the experimental task of a single-leg drop-jump followed by an unanticipated landing task from a 30-cm high box. Joint angular changes of the trunk, pelvis, hip, and knee were calculated within the interval from initial contact (IC) to 40ms. Knee and hip moments were calculated as the maximum values within the interval from IC to 40ms. Surface electromyography data from key muscles were analyzed 50ms before and after IC. Independent t-tests were used to compare the effects of different neurocognitive function on the measurement items. Statistical significance was set at p < 0.05. Results The SDMT score was significantly higher in HP group (HP: 77.9 ± 5.5; LP: 66.0 ± 3.4; p < 0.001). The LP group had a significantly greater trunk rotation angular change to the stance leg side (HP: 0.4 ± 0.8; LP: 1.2 ± 0.4; p = 0.020). There were no significant differences between the two groups in terms of joint moments, and muscle activities. Conclusion Differences in neurocognitive function by SDMT were found to be related to differences in motor strategies of the trunk in the horizontal plane. Although trunk motion in the sagittal and frontal planes during single-leg drop-jump landing increases the ACL injury risk by affecting knee joint motion, the effect of trunk motion in the horizontal plane remains unclear. [ABSTRACT FROM AUTHOR]