Gluteal muscle atrophy, increased gluteal fatty infiltration and hip strength deficits were evident in the affected hips of OA participants. Since severity of OA was related to the extent of atrophy and fatty deposits, rehabilitation programs targeting these muscles could reverse or halt the progression of these structural and functional deficits.

Blended learning has become increasingly common in higher education. Recent findings suggest that blended learning achieves better student outcomes than traditional face-to-face teaching in gross anatomy courses. While face-to-face content is perceived as important to learning there is less evidence for the significance of online content in improving student outcomes. Students enrolled in a second-year anatomy course from the physiotherapy (PT), exercise physiology (EP), and exercise science (ES) programs across two campuses were included (n = 500). A structural equation model was used to evaluate the relationship of prior student ability (represented by grade in prerequisite anatomy course) and final course grade and whether the relationship was mediated by program, campus or engagement with the online elements of the learning management system (LMS; proportion of documents and video segments viewed and number of interactions with discussion forums). PT students obtained higher grades and were more likely to engage with online course materials than EP and ES students. Prerequisite grade made a direct contribution to course final grade (P < 0.001) but was also mediated by engagement with LMS videos and discussion forums (P < 0.001). Student learning outcomes in a blended anatomy course can be predicted the by level of engagement with online content. Anat Sci Educ 11: 471-477. © 2017 American Association of Anatomists.

To analyse the effect of exercise-based rehabilitation programs for improving lower limb muscle strength in individuals with hip or knee osteoarthritis (OA). A systematic search utilizing seven databases identified randomized controlled trials (RCTs) evaluating lower limb strength outcomes of exercise-based interventions for participants with hip or knee OA. All studies were screened for eligibility and methodological quality. Quality of evidence was assessed using Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Data were pooled and meta-analyses performed where appropriate. Forty RCTs were included and the majority (77%) involved resistance based exercise programs. For knee OA populations, there was high quality evidence for improved knee extension (standardized mean difference (SMD) = 0.47, 95% confidence intervals (CI) 0.29, 0.66) and flexion strength (SMD = 0.74, 95% CI 0.56, 0.92) with low-intensity resistance program when compared to a control at short term (ST) follow-up. There was moderate quality evidence for a large effect favouring high-intensity resistance programs (SMD = 0.76, 95% CI 0.47, 1.06) when compared to a control. This effect was sustained at intermediate term (IT) follow-up (SMD = 0.80, 95% CI 0.44, 1.17). Few studies reported on outcomes at long term (LT) follow-up. Only one study reported on a population with hip OA. When compared to a control group, high-intensity resistance exercise demonstrated moderate quality of evidence for large and sustained improvements for knee muscle strength in knee OA patients. Further work is needed to compare different modes of exercise at a LT follow-up for knee OA patients and to address the dearth of literature evaluating exercise interventions in people with hip OA.

Osteoarthritis mainly affects weight-bearing joints such as the hip and knee and is the most common form of arthritis. Greater muscle atrophy with fatty infiltration of gluteal muscles and decreased hip abduction strength has previously been identified with increasing severity of radiological hip OA. However, it is well documented that radiographic findings of OA do not always correlate with clinical severity. The aim of this secondary analysis was to examine whether atrophy and strength of gluteus maximus (GMax), medius (GMed), minimus (GMin), and tensor fascia lata (TFL) is associated with the clinical severity of OA. Twenty participants with unilateral hip OA and 20 age- and sex-matched asymptomatic controls were classified on the basis of clinical severity (mild, moderate-severe and asymptomatic groups) using the Oxford hip score. Muscle volumes of GMax, GMed, GMin, and TFL were determined using magnetic resonance imaging and expressed as asymmetry between limbs. A hand-held dynamometer was used to identify hip rotation and abduction strength. Regression analyzes were used to identify the association between muscle asymmetry and patient-reported severity of hip OA. Both symptomatic groups (mild and moderate-severe) demonstrated significant asymmetry in GMax (P < 0.01) and GMin (P < 0.01). GMed asymmetry was associated with only the moderate-severe symptomatic group. Hip abduction strength was reduced in both symptomatic groups. Gluteal muscle atrophy was associated with the clinical severity of OA. Clinical severity could be a useful tool for clinicians interpreting likely gluteal muscle changes and planning rehabilitation strategies for hip OA patients. Clin. Anat. 31:507-513, 2018. © 2018 Wiley Periodicals, Inc.

Hip abductor strength is reduced in OA patients when compared to healthy controls and to the unaffected limb. Data on muscle size and activity is limited.