Pelvic Drop Changes due to Proximal Muscle Strengthening Depend on Foot-Ankle Varus Alignment

Abstract

Background. Strengthening of hip and trunk muscles can modify pelvis and hip movements. However, the varus alignment of the foot-ankle complex (FAC) may influence the effects of muscle strengthening, due to the relationship of FAC alignment with pelvic and hip kinematics. This study evaluated the effects of hip and trunk muscle strengthening on pelvis and hip kinematics during walking, in subgroups with larger and smaller values of FAC varus alignment. In addition, this study evaluated the effects of hip and trunk muscle strengthening on hip passive and active properties, in the same subgroups. Methods. Fifty-three women, who were divided into intervention and control groups, participated in this nonrandomized controlled trial. Each group was split into two subgroups with larger and smaller values of FAC varus alignment. Hip and trunk muscle strengthening was performed three times a week for two months, with a load of 70% to 80% of one repetition maximum. Before and after strengthening, we evaluated (1) pelvis and hip excursions in the frontal and transverse planes during walking, (2) isokinetic hip passive external rotator torque, and (3) isokinetic concentric and eccentric peak torques of the hip external rotator muscles. Mixed analyses of variance (ANOVAs) were carried out for each dependent variable related to walking kinematics and isokinetic measurements (α=0.05). Results. The subgroup with smaller varus alignment, of the intervention group, presented a reduction in pelvic drop after strengthening (P=0.03). The subgroup with larger varus alignment increased pelvic drop after strengthening, with a marginal significance (P=0.06). The other kinematic excursions did not change (pelvic anterior rotation P=0.30, hip internal rotation P=0.54, and hip adduction P=0.43). The intervention group showed increases in passive torque (P=0.002), peak concentric torque (P<0.001), and peak eccentric torque (P<0.001), independently of FAC alignment. These results suggest that FAC varus alignment influences the effects of strengthening and should be considered when hip and trunk muscle strengthening is used to reduce pelvic drop during walking.

Is there a dose-response of medial wedge insoles on lower limb biomechanics in people with pronated feet during walking and running?

“…The literature indicates that foot pronation and related lower limb movements, in weight-bearing tasks, have a multicausal and individual nature [24]. The presence of excessive foot pronation may be due to a combination of different biomechanical features, such as foot-ankle bone alignment [25,26], midfoot and hip passive stiffness and mobility [25,27,28], and hip strength [29], which will vary depending on an individual's presentation. Therefore, the standardized intervention used may be considered a limitation of the present study.…”

Alinhamento dinâmico do joelho e equilíbrio pélvico: Comparação entre os sexos em atletas de futebol de base

“…9,23,24 However, other factors require further analysis. 7,25 In decelerating sport movements, women have lower knee flexion angles during the initial contact with the ground, because they present a biomechanical decrease in hip-flexion angles. 3 The muscles surrounding the hip joint play a key role in stabilization during movement, especially in the dynamic frontal knee alignment; 26 as such, weakened hip muscles can render women more susceptible to sports injuries, especially those with increased severity, including to the knee ligaments.…”

“…21 De fato, o desalinhamento de membros inferiores existe no esporte, 22 e parece que a população feminina, por menor estabilidade articular e maior fraqueza na musculatura da cintura pélvica, é a que apresenta maiores variações angulares no plano frontal, 9,23,24 apesar de existirem outros fatores que precisam ser analisados. 7,25 Durante a desaceleração dos movimentos esportivos, as mulheres apresentam menores ângulos de flexão do joelho no contato inicial com o solo, por apresentarem biomecanicamente uma diminuição dos ângulos de flexão do quadril. 3 Os músculos que circundam a articulação do quadril desempenham um papel fundamental na estabilização durante o movimento, principalmente do alinhamento dinâmico do joelho no plano frontal, 26 e essa fraqueza pode tornar as mulheres mais susceptíveis a lesões no esporte, principalmente lesões mais graves, como nos ligamentos da articulação do joelho.…”

Hip passive stiffness is associated with midfoot passive stiffness

“…Nevertheless, this is a valid measure 10 in which the examiner presented excellent reliability. In addition, although the method we used to measure shank-forefoot alignment is reliable and has been previously used in different studies, 3,23,25,26 there are no data about its concurrent validity with radiographic measurement. Moreover, we only used one of the measures of midfoot passive mechanical resistance provided by the Foot Torsimeter.…”