Hip Muscle Strength Predicts Noncontact Anterior Cruciate Ligament Injury in Male and Female Athletes

Khayambashi, Khalil; Ghoddosi, Navid; Straub, Rachel K.; Powers, Christopher M.

doi:10.1177/0363546515616237

Cited by 249 publications

(208 citation statements)

References 27 publications

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“…Potentially, this requires adequate hip girdle strength to maintain stability of the pelvis and trunk throughout the test. Although relationships have been reported between various components of lower-extremity and core strength and injury, [7][8][9] the relationship between hip strength and performance on the Y Balance Test has yet to be fully elucidated. [10][11][12] Only 2 studies to date have assessed correlations between the SEBT or Y Balance Test and hip strength.…”

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confidence: 99%

The Relationship Between Hip Strength and the Y Balance Test

Wilson¹,

Robertson²,

Burnham³

et al. 2018

Journal of Sport Rehabilitation

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The authors found the strongest association between the Y Balance Test and hip abduction strength. They also showed smaller but significant associations with hip extension and external rotation strength. When entered into a linear regression analysis, hip abduction strength was the only significant predictor of Y Balance performance. Using this information, practitioners should look to hip abduction strength when patients exhibit deficits in the Y Balance Test.

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confidence: 99%

The Relationship Between Hip Strength and the Y Balance Test

Wilson¹,

Robertson²,

Burnham³

et al. 2018

Journal of Sport Rehabilitation

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“…Though the database used for the present study did not contain information that would help identify the source of increased anterior asymmetry on the SEBT, such as ankle dorsiflexion range of motion or lower extremity muscle strength imbalances, previous research suggests that deficits in strength, flexibility, and neuromuscular control may influence injury risk. 14,18,26 To facilitate development of screening and training programs that effectively reduce injury risk, future research should aim to determine the underlying causes of increased anterior asymmetry. Sideto-side asymmetry normalized to limb length has been previously described in healthy Division I collegiate athletes, 27 but to the authors' knowledge, the present study is the first to associate these values with injury.…”

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confidence: 99%

Star Excursion Balance Test Anterior Asymmetry Is Associated With Injury Status in Division I Collegiate Athletes

Stiffler¹,

Bell²,

Sanfilippo³

et al. 2017

Journal of Orthopaedic & Sports Physical Therapy

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Study Design Retrospective cohort. Background Star Excursion Balance Test (SEBT) performance differs by sport in healthy collegiate athletes, and lower extremity injury rates also vary by sport, sex, and athletic exposure. The relationship between SEBT performance and injury risk has not been evaluated with consideration of these additional variables, which may be necessary to fully describe the relationship between SEBT performance and injury risk. Objectives To assess the association between preseason SEBT performance and noncontact injury occurrence to the knee or ankle in Division I collegiate athletes when controlling for sport, sex, and athletic exposure. Methods Star Excursion Balance Test performance, starting status, and injury status were reviewed retrospectively in National Collegiate Athletic Association Division I collegiate athletes from a single institution. A total of 147 athletes were healthy at the time of preseason SEBT testing and either remained healthy (n = 118) or sustained a noncontact injury to the knee or ankle (n = 29) during their sport's subsequent competitive season. Side-to-side asymmetries were calculated in each direction as the absolute difference in reach distance between limbs. Star Excursion Balance Test reach distances and asymmetries were compared between groups using multivariable regression, controlling for sport, sex, and athletic exposure (starter, nonstarter). Receiver operating characteristic curves were used to determine optimal sensitivity and specificity for significant models. Results When controlling for sport, sex, and athletic exposure, SEBT side-to-side asymmetry in the anterior direction, expressed as an absolute or normalized to limb length, discriminated between injured and noninjured athletes (area under the curve greater than 0.82). Conclusion Assessing side-to-side reach asymmetry in the anterior direction of the SEBT may assist in identifying collegiate athletes who are at risk for sustaining noncontact injuries to the knee or ankle. Level of Evidence Prognosis, level 2b. J Orthop Sports Phys Ther 2017;47(5):339–346. Epub 29 Mar 2017. doi:10.2519/jospt.2017.6974

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“…Compared to males, females demonstrated lower strength in all directions except extension and greater flexion and IR ROM. Previous studies have also shown females exhibit significant lower hip muscle strength than males in both normal (Kemp, Schache, Makdissi, Sims, & Crossley, 2013) and athletic (Khayambashi, Ghoddosi, Straub, & Powers, 2016) populations, as well as in patients with chondrolabral pathology, 12-24 months post-surgery (Kemp, Schache, Makdissia, Pritchard, Sims et al, 2014d). Other studies have reported that populations of normal and active females demonstrate greater hip flexion (Beneck, Selkowitz, Janzen, Malecha, & Tiemeyer, 2018;Hallaçeli et al, 2014) and IR ROM (Hallaçeli et al, 2014; Moreno-Pérez, Ayala, Fernandez-Fernandez, & Vera-Garcia, 2016) than males.…”

Section: Discussionmentioning

confidence: 93%

Strength and range of movement deficits are associated with symptom severity in people scheduled for hip arthroscopy

Freke

Kemp

Crossley

et al. 2019

European Journal of Pain

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Background Identifying the physical impairments associated with worse symptoms and greater functional limitations in people with hip pain could enable targeted rehabilitation programmes designed to improve quality of life. The objective of this study was to compare physical characteristics between subgroups of symptoms and functional limitation severity in individuals with hip pain scheduled for arthroscopic surgery. Methods Hip range of motion (ROM) and muscle strength were measured in 114 individuals (48 women; aged 32 ± 8 years) with hip pain scheduled for hip arthroscopy. Pain and disability were measured with the International Hip Outcome Tool (iHOT33) subscale of Symptoms and Functional Limitation, and a cluster analysis was used to identify mild, moderate and severe subgroups. Between‐group differences were then evaluated using multivariate analysis of covariance, including sex as a covariate, followed by post hoc testing. Significance was set at 0.05. Results Lesser hip muscle strength in all directions was reported in the severe symptoms and functional limitation group compared to the mild group. Hip flexion ROM differed when comparing the moderate to both the mild and severe subgroups. Hip internal rotation did not differ between subgroups of severity. Conclusions Individuals with hip pain and severe scores in the iHOT33 subscale of symptoms and functional limitations present with significantly lesser hip muscle strength and hip flexion ROM than individuals with moderate or mild scores. Targeted programmes to improve hip strength and flexion ROM in more severe patients may help reduce symptoms and improve function. Significance Individuals with severe hip pain and functional limitation possess significantly lesser muscle strength and flexion ROM than individuals with moderate or mild scores.

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Hip Muscle Strength Predicts Noncontact Anterior Cruciate Ligament Injury in Male and Female Athletes

Cited by 249 publications

References 27 publications

The Relationship Between Hip Strength and the Y Balance Test

The Relationship Between Hip Strength and the Y Balance Test

Star Excursion Balance Test Anterior Asymmetry Is Associated With Injury Status in Division I Collegiate Athletes

Strength and range of movement deficits are associated with symptom severity in people scheduled for hip arthroscopy

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