Do hip-abduction braces work?—A biomechanical evaluation of a commercially available hip brace

Abstract Introduction Dislocations of the hip joint are a common and clinically relevant complication following total hip arthroplasty (THA). Hip-abduction braces are currently used following operative or non-operative treatment of THA dislocations to prevent re-dislocations. However, the clinical and biomechanical effectiveness of such braces is still controversial. Material and methods A total of 30 volunteers were measured during standing and during sitting up and down from a chair task wearing a hip brace set at 70°, 90° or no hip flexion limitation. Range of motion of the hip joint was measured in all directions by an inertial sensor system. Further it has been evaluated if the range of motion would be reduced by the additional use of an arthrodesis cushion. Results The use of a hip brace set up with flexion limitation did reduce hip ROM in all directions significantly compared to unhinged brace (p < 0.001–0.035). Performing the “sit down and stand-up task” the brace set up at 70° flexion limitation did reduce maximum hip flexion significantly (p = 0.008). However, in most cases the measured hip flexion angles were greater than the settings of the hip brace should have allowed. The additional use of a cushion can further limit hip motion while sitting up and down from a chair. Conclusion This study has demonstrated that hip-abduction braces reduce hip range of motion. However, we also found that to achieve a flexion limitation of the hip to 90°, the hip brace should be set at a 70° hip flexion limitation.

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Socket Versus Bone-Anchored Trans-Femoral Prostheses: Hip Range of Motion and Sitting Comfort

Prosthetics and Orthotics International ◽

10.1080/03093640500238014 ◽

2005 ◽

Vol 29 (2) ◽

pp. 153-163 ◽

Cited By ~ 111

Author(s):

K. Hagberg ◽

E. Häggström ◽

M. Uden ◽

R. Brånemark

Keyword(s):

Range Of Motion ◽

Study Group ◽

Prosthetic Socket ◽

Hip Range Of Motion ◽

Hip Motion ◽

Hip Flexion

This is the first study to report on hip range of motion (ROM) among active prosthesis users, when wearing and not wearing a trans-femoral socket prosthesis and to compare with individuals rehabilitated with an osseointegrated bone-anchored prosthesis. In addition, discomfort when sitting with the prosthesis is reported in both groups. The study group all had a non-vascular amputation and were divided into those supplied with a socket prosthesis (S group) ( n = 43, mean age 51 years, 74% men) or a bone-anchored prosthesis (OI group) ( n = 20, mean age 46 years, 75% men). Active hip ROM was measured with a goniometer, and self-reported problems with discomfort when sitting were recorded. The hip motion decreased in all directions when wearing the socket prosthesis compared to without it ( P < 0.001 for all directions), and 37% of the subjects had less than 90° of hip flexion when wearing their prosthesis. Discomfort when sitting was reported among 44% ( n = 19) in the S group and was more common among individuals with less than 90° of hip flexion motion ( P = 0.025). In the OI group, no restriction in hip motion was measured with the prosthesis, and no subject had less than 90° of flexion and 5% ( n = 1) reported discomfort when sitting. This study shows that a trans-femoral prosthetic socket significantly reduces the ROM of the hip and that discomfort when sitting is common among individuals wearing such prostheses. Further, the study confirms that individuals using a bone-anchored prosthesis have no restricted hip motion with the prosthesis and report very few problems with discomfort when sitting.

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Can the Open Stance Forehand Increase the Risk of Hip Injuries in Tennis Players?

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120966297 ◽

2020 ◽

Vol 8 (12) ◽

pp. 232596712096629

Author(s):

Caroline Martin ◽

Anthony Sorel ◽

Pierre Touzard ◽

Benoit Bideau ◽

Ronan Gaborit ◽

...

Keyword(s):

Hip Joint ◽

Inverse Dynamics ◽

External Rotation ◽

Tennis Players ◽

Flexion Extension ◽

Hip Injuries ◽

Hip Motion ◽

Hip Kinematics ◽

The Right ◽

Hip Flexion

Background: The open stance forehand has been hypothesized by tennis experts (coaches, scientists, and clinicians) to be more traumatic than the neutral stance forehand as regards hip injuries in tennis. However, the influence of the forehand stance (open or neutral) on hip kinematics and loading has not been assessed. Purpose: To compare the kinematics and kinetics at the hip joint during 3 common forehand stances (attacking neutral stance [ANS], attacking open stance [AOS], defensive open stance [DOS]) in advanced tennis players to determine whether the open stance forehand induces higher hip loading. Study Design: Descriptive laboratory study. Methods: The ANS, AOS, and DOS forehand strokes of 8 advanced right-handed tennis players were recorded with an optoelectronic motion capture system. The flexion-extension, abduction-adduction, and external-internal rotation angles as well as intersegmental forces and torques of the right hip were calculated using inverse dynamics. Results: The DOS demonstrated significantly higher values than both the ANS and AOS for anterior ( P < .001), medial ( P < .001), and distractive ( P < .001) forces as well as extension ( P = .004), abduction ( P < .001), and external rotation ( P < .001) torques. The AOS showed higher distractive forces than the ANS ( P = .048). The DOS showed more extreme angles of hip flexion ( P < .001), abduction ( P < .001), and external rotation ( P = .010). Conclusion: The findings of this study imply that the DOS increased hip joint angles and loading, thus potentially increasing the risk of hip overuse injuries. The DOS-induced hip motion could put players at a higher risk of posterior-superior hip impingement compared with the ANS and AOS. Clinical Relevance: Coaches and clinicians with players who have experienced hip pain or sustained injuries should encourage them to use a more neutral stance and develop a more aggressive playing style to avoid the DOS, during which hip motion and loading are more extreme.

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Validation of Novel Relative Orientation and Inertial Sensor-to-Segment Alignment Algorithms for Estimating 3D Hip Joint Angles

Sensors ◽

10.3390/s19235143 ◽

2019 ◽

Vol 19 (23) ◽

pp. 5143 ◽

Cited By ~ 3

Author(s):

Lukas Adamowicz ◽

Reed Gurchiek ◽

Jonathan Ferri ◽

Anna Ursiny ◽

Niccolo Fiorentino ◽

...

Keyword(s):

Range Of Motion ◽

Hip Joint ◽

Inertial Sensor ◽

Estimation Error ◽

Relative Orientation ◽

Joint Angles ◽

Alignment Algorithms ◽

Sensor Orientation ◽

Flexion Extension ◽

Optical Motion

Wearable sensor-based algorithms for estimating joint angles have seen great improvements in recent years. While the knee joint has garnered most of the attention in this area, algorithms for estimating hip joint angles are less available. Herein, we propose and validate a novel algorithm for this purpose with innovations in sensor-to-sensor orientation and sensor-to-segment alignment. The proposed approach is robust to sensor placement and does not require specific calibration motions. The accuracy of the proposed approach is established relative to optical motion capture and compared to existing methods for estimating relative orientation, hip joint angles, and range of motion (ROM) during a task designed to exercise the full hip range of motion (ROM) and fast walking using root mean square error (RMSE) and regression analysis. The RMSE of the proposed approach was less than that for existing methods when estimating sensor orientation ( 12 . 32 ∘ and 11 . 82 ∘ vs. 24 . 61 ∘ and 23 . 76 ∘ ) and flexion/extension joint angles ( 7 . 88 ∘ and 8 . 62 ∘ vs. 14 . 14 ∘ and 15 . 64 ∘ ). Also, ROM estimation error was less than 2 . 2 ∘ during the walking trial using the proposed method. These results suggest the proposed approach presents an improvement to existing methods and provides a promising technique for remote monitoring of hip joint angles.

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Activity and Quality of Life after Total Hip Arthroplasty

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0010.5823 ◽

2017 ◽

Vol 19 (5) ◽

pp. 0-0 ◽

Cited By ~ 2

Author(s):

Anna Świtoń ◽

Ewa Wodka-Natkaniec ◽

Łukasz Niedźwiedzki ◽

Tadeusz Gaździk ◽

Tadeusz Niedźwiedzki

Keyword(s):

Quality Of Life ◽

Total Hip Arthroplasty ◽

Range Of Motion ◽

Hip Joint ◽

Hip Arthroplasty ◽

External Rotation ◽

Harris Hip Score ◽

Joint Analysis ◽

Total Hip

Background. Coxarthrosis is a chronic musculoskeletal condition that causes severe pain and considerable limitation of the patient’s motor performance. Total hip arthroplasty is one of the most common and effective methods used in the treatment of advanced degenerative changes. The aim of the present study was to evaluate the activity and quality of life of patients after unilateral total hip arthroplasty. Material and methods. The study was conducted in a group of 189 patients who had undergone unilateral total hip arthroplasty. Goniometry was used to determine the range of motion of both hip joints. Patients’ physical ability and pain severity were assessed based on the Harris Hip Score (HHS) questionnaire. Results. The examination of the range of motion in the lower extremities revealed statistically significant differences in flexion (p<0.01), abduction (p=<0.01), adduction (p<0.01) and external rotation (p<0.01) between the operated and the healthy extremity. The greatest limitation of motion was demonstrated for external rotation (<14°). Approximately 14% of the patients were not able to perform this motion in their healthy hip joint, while 17.5% of them could not do so in the affected hip joint. Analysis of HHS results (mean = 79 pts) revealed that more than 50% of the patients described their functional ability and quality of life as good and excellent. It was demonstrated that 54% of patients did not suffer from pain, whereas minor or mild pain was noted in 35%. Conclusions: 1. A subjective clinical assessment of patients after total hip arthroplasty showed that their quality of life had improved. 2. It is necessary to perform physiotherapy after total hip arthroplasty, on both the operated and healthy side. 3. Exacerbation of pain and impaired activity in patients after total hip arthroplasty were associated with the female sex to a considerable extent.

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Anatomical Hip Range of Motion After Implantation During Total Hip Arthroplasty With a Large Change in Pelvic Inclination

The Journal of Arthroplasty ◽

10.1016/j.arth.2012.03.002 ◽

2012 ◽

Vol 27 (9) ◽

pp. 1641-1650.e1 ◽

Cited By ~ 29

Author(s):

Hidenobu Miki ◽

Takayuki Kyo ◽

Nobuhiko Sugano

Keyword(s):

Total Hip Arthroplasty ◽

Range Of Motion ◽

Hip Arthroplasty ◽

Large Change ◽

Total Hip ◽

Pelvic Inclination ◽

Hip Range Of Motion

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Influence of body mass index on sagittal hip range of motion and gait speed recovery six months after total hip arthroplasty

International Orthopaedics ◽

10.1007/s00264-018-4250-y ◽

2019 ◽

Vol 43 (11) ◽

pp. 2447-2455 ◽

Cited By ~ 3

Author(s):

Pierre Martz ◽

Abderrahmane Bourredjem ◽

Jean Francis Maillefert ◽

Christine Binquet ◽

Emmanuel Baulot ◽

...

Keyword(s):

Body Mass Index ◽

Total Hip Arthroplasty ◽

Range Of Motion ◽

Body Mass ◽

Hip Arthroplasty ◽

Gait Speed ◽

Total Hip ◽

Hip Range Of Motion

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Comparison of goniometric measurement reliability of hip joint flexion and proximal interphalangeal joint flexion in healthy adults

South African Journal of Physiotherapy ◽

10.4102/sajp.v55i4.578 ◽

1999 ◽

Vol 55 (4) ◽

pp. 24-28

Author(s):

H. Okeke

Keyword(s):

Range Of Motion ◽

Hip Joint ◽

Middle Finger ◽

Proximal Interphalangeal Joint ◽

Measurement Reliability ◽

Joint Measurement ◽

Joint Flexion ◽

Hip Flexion ◽

Joint Motions ◽

Joint Range

Background For many reasons’ physiotherapists measure joint range of motion of their patients. There are usually variations in measurement values of each motion when measured either by the same person or by different observers. Also, reliability studies have resulted in varying levels of reliability coefficients. The purpose of this study was to compare the goniometric measurement reliability of a complex joint represented by the hip joint and a simple joint represented by proximal interphalangeal (PIP) flexion motions and to assess whether the two joint motions could be equally reliably measured by the same person under the same test and retest conditions. Method Thirty-three healthy subjects between the ages of 23 and 34 years participated. In order to assess the repeatability of measurements in the two selected joint motions, the r. level of each joint measurement was determined and their goniometric measurement reliability compared. Result Results were based on data collected by measuring the flexion range of motion of right hips and right middle finger PIP joints in normal adults. Statistical analyses indicated that there were significant differences between goniometric measurement reliability in hip and PIP flexion motions. Conclusion Two joints were goniometrically measured by the same tester under the same test condition. Reliability measurements results were compared in thirty-three adults. Based on the study, the researcher concluded that the goniometric measurement of hip flexion motion is more variable than that of PIP flexion motion.

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Reliability of hip range of motion measurement among experienced arthroscopic hip preservation surgeons

Journal of Hip Preservation Surgery ◽

10.1093/jhps/hnz062 ◽

2019 ◽

Vol 7 (1) ◽

pp. 77-84 ◽

Cited By ~ 1

Author(s):

Joshua D Harris ◽

Richard C Mather ◽

Shane J Nho ◽

John P Salvo ◽

Allston J Stubbs ◽

...

Keyword(s):

Range Of Motion ◽

Pelvic Tilt ◽

External Rotation ◽

Level Of Evidence ◽

Motion Measurement ◽

Hip Range Of Motion ◽

Asymptomatic Volunteers ◽

Hip Flexion ◽

Hip Internal Rotation ◽

Intra Class Correlation Coefficient

Abstract The aim of this study was to determine (i) the reliability of hip range of motion measurement among experienced arthroscopic hip preservation surgeons and (ii) the magnitude of hip flexion change with posterior pelvic tilt. Five experienced arthroscopic hip preservation surgeons (5–18 years of hip surgery experience) performed passive hip range of motion (internal and external rotation), flexion (contralateral hip extended) and flexion with posterior pelvic tilt (contralateral hip maximally flexed) on five young healthy asymptomatic volunteers (three males, two females; 34.4 ± 10.7 years of age). Motion was measured via digital photography and goniometry. Inter-observer reliability was calculated via two-way mixed, single measures, intra-class correlation coefficient. Paired t-test was utilized to compare hip flexion (with contralateral hip extended) to hip flexion with posterior pelvic tilt (with contralateral hip in forced flexion). The reliabilities of measurements of hip flexion with posterior pelvic tilt and external rotation were excellent, that of hip flexion was fair, and that of hip internal rotation was poor. The magnitude of hip flexion increase with posterior pelvic tilt was 17.0° ± 3.0° (P < 0.001). The reliability of hip range of motion measurement by five experienced arthroscopic hip preservation surgeons was excellent for measures of hip flexion with posterior pelvic tilt and external rotation. Contralateral maximal hip flexion significantly increased ipsilateral hip flexion (approximately 17°). Level of Evidence: Diagnostic, level III (without consistently applied reference standard)

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