The Biomechanical Demands on the Hip During Progressive Stepping Tasks

Abstract

Hatfield, GL, Charlton, JM, Cochrane, CK, Hammond, CA, Napier, C, Takacs, J, Krowchuk, NM, and Hunt, MA. The biomechanical demands on the hip during progressive stepping tasks. J Strength Cond Res 31(12): 3444-3453, 2017-Functional hip strengthening exercises are important components of lower extremity (LE) rehabilitation and include single-leg squats (SLS), step-downs (SD), and step-ups (SU). The biomechanical demand of these tasks is unclear. This repeated-measures study determined hip biomechanical demands in a healthy population. Twenty individuals (10 men, 26.6 ± 5.1 years, 22.1 ± 2.3 kg·m) participated. Three-dimensional motion, ground reaction force data, and surface electromyograms (EMG) were recorded during 4 randomly ordered tasks. Outcomes included frontal and sagittal plane hip moment impulses and muscle activity for each task. Repeated measures analysis of variance models (alpha = 0.05) determined between-task differences. Step-down and SLS were most biomechanically demanding, with significantly higher hip flexion and adduction moment impulses, and gluteus medius (GM) and quadriceps activity compared with half step-down (HSD) and SU. No significant difference was found between SD and SLS, indicating minimal difference in demand between the 2 tasks, likely due to kinematic similarities in performance; there were no significant differences in knee or hip sagittal plane angle excursion, or peak pelvic obliquity angle between the 2 tasks. Step-up was least demanding, with the lowest hip flexion and adduction moment impulses and GM, quadriceps, and hamstrings activity. Step-up was least demanding on the hip and would be a good starting task for hip strengthening protocols. Step-down and SLS were most demanding, requiring higher hip moments and muscle activity. These results provide evidence, which may be used in planning of progressive rehabilitation programs for patients with LE pathologies.

Electromyographic activity in the gluteus medius, gluteus maximus, biceps femoris, vastus lateralis, vastus medialis and rectus femoris during the Monopodal Squat, Forward Lunge and Lateral Step-Up exercises

“…However, the differences in EMG activity that were found by these authors were lower in comparison to those of the present study, possibly because these authors used lower loads (the participants' body weights) as well as lower boxes (15.24 cm), compared to the present study. Most recently, Haltfield et al [48] also found greater activation in the VL and VM, followed by…”

“…We found no study that specifically used this load, since the literature features a great deal of heterogeneity regarding the loads that are used in the studies of sEMG. Most of the studies on unilateral exercises usually use the participant's own body weight because they are oriented toward rehabilitation purposes [22,48,51,55,57]. Deforest et al [31] used 85% 1 RM to analyze Double-leg squats and 50% of said load for Single-leg squats.…”

Evidence for Reliability and Validity of Functional Performance Testing in the Evaluation of Nonarthritic Hip Pain

“…1,2 The overall normal movement patterns during descent in both the SLST and SDT include hip and knee flexion with anterior pelvic tilt, trunk flexion, and hip adduction with knee internal rotation and abduction. 1,3,4 Visual observation of the SLST and SDT has been shown to be reliable for evaluating kinematic and biomechanical deficiencies of the hip, pelvis, and trunk in healthy people. 5,6 These tests have also been established as valid for assessing dynamic lower extremity control and hip muscle function in both healthy people and those with diagnosed hip chondropathy.…”

“…1 An increase in hip-abduction kinematics needed during the SDT can cause greater activation of the medial and lateral hamstrings as compared with the SLST. 4 Conditions associated with hip-joint pain in the absence of severe degenerative joint disease are defined as nonarthritic hip pain and include femoroacetabular impingement (FAI), acetabular labral tears, dysplasia, structural instability (ie, acetabular retroversion, femoral anteversion), and ligamentum teres tears. 11,12 These conditions are believed to result from repetitive microtrauma that occurs during dynamic movement between the proximal femur and the acetabulum.…”

“…[14][15][16] With increased attention on nonarthritic hip injuries, 17,18 these conditions are being identified and diagnosed more commonly, especially in the young, athletic population. Although functional performance tests are commonly used to evaluate active people with hip pain and dysfunction, 1,4,19 studies establishing their reliability and validity in patients with nonarthritic hip pain are limited.…”