Measuring hip muscle strength in patients with femoroacetabular impingement and other hip pathologies

Mayne, E; Memarzadeh, Arman; Raut, P; Arora, Arvind; Khanduja, Vikas

doi:10.1302/2046-3758.61.bjr-2016-0081

Cited by 21 publications

(30 citation statements)

References 37 publications

(64 reference statements)

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“…Systematic reviews included in the evidence summary consistently report lower muscle strength for hip adduction, abduction, flexion, internal rotation and external rotation in individuals with hip-related pain compared with individuals without pain 8 9 19. However, there is conflicting evidence whether extension strength deficits are found in this population (online supplementary appendix).…”

Section: Discussionmentioning

confidence: 99%

Standardised measurement of physical capacity in young and middle-aged active adults with hip-related pain: recommendations from the first International Hip-related Pain Research Network (IHiPRN) meeting, Zurich, 2018

et al. 2019

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Hip-related pain can significantly impact quality of life, function, work capacity, physical activity and family life. Standardised measurement methods of physical capacity of relevance to young and middle-aged active adults with hip-related pain are currently not established. The aim of this consensus paper was to provide recommendations for clinical practice and research on standardised measurement methods of physical capacity in young and middle-aged active adults with hip-related pain. Four areas of importance were identified: (1) clinical measures (range of motion, muscle strength, functional impairments), (2) laboratory-based measures (biomechanics and muscle function (muscle activity, size and adiposity)), (3) physical activity, and (4) return to sport/performance. The literature was reviewed, and a summary circulated to the working group to inform discussion at the consensus meeting. The working group developed clinical and research recommendations from the literature review, which were further discussed and modified within the working group at the consensus meeting. These recommendations were then presented to all 38 International Hip-related Pain Research Network (IHiPRN) participants for further discussion, refinement and consensus voting. Therefore, the recommendations voted on were based on a combination of current evidence and expert opinion. The consensus meeting voted on 13 recommendations, six of which were clinically orientated, and seven more research specific. We recommended that clinicians working with young and middle-aged active adults with hip-related pain assess strength using objective methods of measurement, and clinically assess performance of functional tasks, including walking and running. Physical activity should be quantified using both self-reported and objective measures, and patient expectations of recovery should be quantified prior to treatment. It was recommended that return to physical activity (including sport and occupation) be quantified, and sport-specific activities should be assessed prior to return to sport. The IHiPRN participants were uncertain regarding recommendations for range of motion assessment. Research recommendations were that the measurement properties of range of motion, strength and functional performance tests be investigated, reported and improved in both clinical and research settings. Reporting of movement-related parameters (biomechanics and muscle function) should be standardised and the relationship among movement-related parameters, symptoms, function, quality of life, and intra-articular and imaging findings should be investigated. Quantification of return to physical activity (including sport and occupational demands) is required in future research, and the return to sport continuum should be used. Future research is required to determine the best criteria for rehabilitation progression and return to physical activity following hip-related pain management.

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Section: Discussionmentioning

confidence: 99%

Standardised measurement of physical capacity in young and middle-aged active adults with hip-related pain: recommendations from the first International Hip-related Pain Research Network (IHiPRN) meeting, Zurich, 2018

et al. 2019

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“…Changes in neuromuscular function of the hip are associated with intra‐articular hip joint pathology. Recent systematic reviews (Diamond et al, ; Freke et al, ; Mayne et al, ) and research studies have examined physical impairments associated with FAI syndrome, acetabular labral pathology and chondropathology, and have found impaired hip range of motion (Kemp et al, ; Diamond et al, ), reduced hip muscle strength (Casartelli et al, ; Harris‐Hayes et al, ; Mendis et al, ; Kemp et al, ; Nepple et al, ; Diamond et al, ), impaired functional task performance (Hatton et al, ; Bagwell et al, ; Charlton et al, ; Kemp et al, ; Samaan et al, ), and altered gait biomechanics (Kennedy et al, ; Brisson et al, ; Hunt et al, ; Ng et al, ). With respect to hip muscle size, previous research has investigated size of the gluteal muscles in patients with chronic hip joint pain (Mastenbrook et al, ) and of the individual hip flexor muscles in patients with acetabular labral pathology (Mendis et al, ); however, no research to date has investigated the individual hip abductor, hip extensor, or hip external rotator muscles in this patient population.…”

Section: Introductionmentioning

confidence: 99%

Hip muscle atrophy in patients with acetabular labral joint pathology

et al. 2019

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Intra‐articular hip joint pathology is a source of hip and groin pain in active individuals and is thought to be a precursor to hip osteoarthritis. Limited evidence exists to guide appropriate physiotherapy management for these patients. Identification of which hip muscles are affected may help clinicians to develop effective exercise programs. A cross‐sectional observational study in a hospital setting was conducted to investigate the size of individual hip abductor, hip extensor, and hip external rotator muscles in patients with acetabular labral joint pathology compared with age and sex matched healthy subjects. Twelve participants (eight females, four males), aged 20–53 years, with a medical diagnosis of unilateral acetabular labral tear and 12 healthy participants were recruited. Magnetic resonance imaging was used to assess cross‐sectional areas of the gluteus minimus, gluteus medius, upper gluteus maximus, lower gluteus maximus, piriformis, and quadratus femoris muscles bilaterally. Gluteus medius muscle cross‐sectional area was significantly different between groups (P < 0.01, effect size = 0.92) with muscle size found to be smaller in the pathology group. No differences were found for the other hip muscles (P > 0.05). These findings suggest that hip muscles are not all affected equally by the presence of intra‐articular hip joint pathology. Atrophy of specific hip muscles, which are important in hip joint and pelvic stability, may alter hip joint function during gait and functional tasks. Clinicians treating patients with intra‐articular hip joint pathology may need to prescribe exercises targeting the specific muscles with demonstrated dysfunction. Clin. Anat. 33:538–544, 2020. © 2019 Wiley Periodicals, Inc.

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“…Furthermore, the differences in joint loading may provide a better strategy for athletic conditioning, training program, or nonsurgical management 5,10,45. As Mayne and associates (2017) recently pointed out that knowledge pertaining to hip muscle strength associated with FAI patients is very limited 49. Although previous studies reported joint kinematics and kinetics associated with cam FAI, none of the studies determined hip contact forces from musculoskeletal modelling, to compare joint loading between a cohort of FAI and CON participants.…”

mentioning

confidence: 99%

Altered Walking and Muscle Patterns Reduce Hip Contact Forces in Individuals With Symptomatic Cam Femoroacetabular Impingement

Mantovani

Modenese

et al. 2018

Am J Sports Med

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Background: Cam-type femoroacetabular impingement (FAI) is a causative factor for hip pain and early hip osteoarthritis. Although cam FAI can alter hip joint biomechanics, it is unclear what role muscle forces play and how they affect the hip joint loading. Purpose/Hypothesis: The purpose was to examine the muscle contributions and hip contact forces in individuals with symptomatic cam FAI during level walking. Symptomatic cam FAI demonstrate different muscle and hip contact forces during gait. Study Design: Controlled laboratory study. Methods: Eighteen patients with symptomatic cam FAI (nFAI = 18) were age-and BMI-matched with eighteen control participants (nCON = 18). Each participant's walking kinematics and kinetics were recorded throughout a gait cycle (ipsilateral foot-strike to ipsilateral foot-off), using a motion capture system and force plates. Muscle and hip contact forces were subsequently computed using a musculoskeletal modelling program and static optimization methods. Results: The FAI group walked slower and with shorter steps; demonstrating reduced joint motions and moments during contralateral foot-strike, compared to the CON group. The FAI group showed reduced psoas major (median = 1.1, interquartile range (IQR) = 1.0-1.5 Newton/bodyweight (N/BW)) and iliacus forces (median = 1.2, IQR = 1.0-1.6 N/BW), during contralateral foot-strike, compared to the CON group (median = 1.6, IQR = 1.3-1.6 N/BW, p = 0.004; and median = 1.5, IQR = 1.3-1.6 N/BW, p = 0.03, respectively); which resulted in lower hip contact forces in the anterior (p = 0.026), superior (p = 0.02), and medial directions (p = 0.038). The three vectors produced a resultant peak force at the anterosuperior aspect of the acetabulum for both groups; with the FAI group demonstrating a substantially lower magnitude. 4 Conclusions: FAI participants altered their walking kinematics and kinetics, especially during contralateral foot-strike as a protective mechanism, and resulted in reduced psoas major and iliacus muscle force and anterosuperior hip contact force estimations. Clinical Relevance: Limited hip mobility is not only attributed to bone-on-bone impingement, caused by the cam morphology, but could be attributed to musculature as well. Not only would the psoas major and iliacus be able to protect the hip joint during flexion-extension, athletic conditioning could further strengthen core muscles for improved hip mobility and pelvic balance.

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Measuring hip muscle strength in patients with femoroacetabular impingement and other hip pathologies

Cited by 21 publications

References 37 publications

Standardised measurement of physical capacity in young and middle-aged active adults with hip-related pain: recommendations from the first International Hip-related Pain Research Network (IHiPRN) meeting, Zurich, 2018

Standardised measurement of physical capacity in young and middle-aged active adults with hip-related pain: recommendations from the first International Hip-related Pain Research Network (IHiPRN) meeting, Zurich, 2018

Hip muscle atrophy in patients with acetabular labral joint pathology

Altered Walking and Muscle Patterns Reduce Hip Contact Forces in Individuals With Symptomatic Cam Femoroacetabular Impingement

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