Patients with early-stage knee osteoarthritis and knee pain have decreased hip abductor muscle strength while descending stairs

IntroductionReduced hip abductor strength may indirectly lead to changes in knee kinematics and functional impairment and has been reported in patients with patellofemoral pain and knee osteoarthritis (OA). Limited information is available regarding hip abductor strength following total or unicompartmental knee arthroplasty (TKA/UKA). The aims of this systematic review are to synthesise the evidence of hip abductor muscle strength deficits in patients following TKA/UKA and to determine influencing factors for these deficits.Methods and analysisEmbase, Medline, SportDiscus, the Web of Science Core Collection and Scopus will be searched for human-based clinical studies investigating hip abductor muscle strength after TKA/UKA for knee OA or avascular necrosis (AVN). Articles studying hip abductor strength after knee arthroplasty for post-traumatic OA will not be considered. No restriction on study design, prosthesis design, surgical approach, patient characteristics or severity of OA/AVN will be applied. We will search articles published between 1 January 1990 and the date of our last search. Only articles in English or German language will be considered for inclusion. Studies reporting manually measured muscle strength or measurements performed at hip abduction angles other than 0° will be excluded. References will be screened by two reviewers independently. Where necessary, a third author will make the final decision. The assessment of quality and risk of bias will be performed with the modified Newcastle-Ottawa scale. Data will be extracted and presented in a tabular form. Depending on availability, comparable subgroup and meta-analyses will be conducted. Patient characteristics such as age, sex and surgical approach or rehabilitation programme will be analysed, if sufficient data are available.Ethics and disseminationNo ethics approval is required. The results will be published in a peer-reviewed journal and as conference presentation.

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Experimentally Reduced Hip-Abductor Muscle Strength and Frontal-Plane Biomechanics During Walking

Journal of Athletic Training ◽

10.4085/1062-6050-49.5.07 ◽

2015 ◽

Vol 50 (4) ◽

pp. 385-391 ◽

Cited By ~ 12

Author(s):

Michael B. Pohl ◽

Karen D. Kendall ◽

Chirag Patel ◽

J. Preston Wiley ◽

Carolyn Emery ◽

...

Keyword(s):

Muscle Strength ◽

Knee Osteoarthritis ◽

Nerve Block ◽

Frontal Plane ◽

Knee Adduction Moment ◽

Abductor Muscle ◽

Hip Abduction ◽

Hip Abductor ◽

Abduction Strength ◽

Abductor Strength

Context Researchers have postulated that reduced hip-abductor muscle strength may have a role in the progression of knee osteoarthritis by increasing the external knee-adduction moment. However, the relationship between hip-abductor strength and frontal-plane biomechanics remains unclear. Objective To experimentally reduce hip-abduction strength and observe the subsequent changes in frontal-plane biomechanics. Design Descriptive laboratory study. Setting Research laboratory. Patients or Other Participants Eight healthy, recreationally active men (age = 27 ± 6 years, height = 1.75 ± 0.11 m, mass = 76.1 ± 10.0 kg). Intervention(s) All participants underwent a superior gluteal nerve block injection to reduce the force output of the hip-abductor muscle group. Main Outcome Measure(s) Maximal isometric hip-abduction strength and gait biomechanical data were collected before and after the injections. Gait biomechanical variables collected during walking consisted of knee- and hip-adduction moments and impulses and the peak angles of contralateral pelvic drop, hip adduction, and ipsilateral trunk lean. Results Hip-abduction strength was reduced after the injection (P = .001) and remained lower than baseline values at the completion of the postinjection gait data collection (P = .02). No alterations in hip- or knee-adduction moments (hip: P = .11; knee: P = .52) or impulses (hip: P = .16; knee: P = .41) were found after the nerve block. Similarly, no changes in angular kinematics were observed for contralateral pelvic drop (P = .53), ipsilateral trunk lean (P = .78), or hip adduction (P = .48). Conclusions A short-term reduction in hip-abductor strength was not associated with alterations in the frontal-plane gait biomechanics of young, healthy men. Further research is needed to determine whether a similar relationship is true in older adults with knee osteoarthritis.

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Changes in Knee Biomechanics After a Hip-Abductor Strengthening Protocol for Runners With Patellofemoral Pain Syndrome

Journal of Athletic Training ◽

10.4085/1062-6050-46.2.142 ◽

2011 ◽

Vol 46 (2) ◽

pp. 142-149 ◽

Cited By ~ 106

Author(s):

Reed Ferber ◽

Karen D. Kendall ◽

Lindsay Farr

Keyword(s):

Muscle Strength ◽

Knee Joint ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Genu Valgum ◽

Abductor Muscle ◽

Muscle Strengthening ◽

Peak Knee ◽

Hip Abductor

Abstract Context: Very few authors have investigated the relationship between hip-abductor muscle strength and frontal-plane knee mechanics during running. Objective: To investigate this relationship using a 3-week hip-abductor muscle-strengthening program to identify changes in strength, pain, and biomechanics in runners with patellofemoral pain syndrome (PFPS). Design: Cohort study. Setting: University-based clinical research laboratory. Patients or Other Participants: Fifteen individuals (5 men, 10 women) with PFPS and 10 individuals without PFPS (4 men, 6 women) participated. Intervention(s): The patients with PFPS completed a 3-week hip-abductor strengthening protocol; control participants did not. Main Outcome Measure(s): The dependent variables of interest were maximal isometric hip-abductor muscle strength, 2-dimensional peak knee genu valgum angle, and stride-to-stride knee-joint variability. All measures were recorded at baseline and 3 weeks later. Between-groups differences were compared using repeated-measures analyses of variance. Results: At baseline, the PFPS group exhibited reduced strength, no difference in peak genu valgum angle, and increased stride-to-stride knee-joint variability compared with the control group. After the 3-week protocol, the PFPS group demonstrated increased strength, less pain, no change in peak genu valgum angle, and reduced stride-to-stride knee-joint variability compared with baseline. Conclusions: A 3-week hip-abductor muscle-strengthening protocol was effective in increasing muscle strength and decreasing pain and stride-to-stride knee-joint variability in individuals with PFPS. However, concomitant changes in peak knee genu valgum angle were not observed.

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Abductor muscle strength deficit in patients after total hip arthroplasty for hip osteoarthritis: a protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-035413 ◽

2020 ◽

Vol 10 (7) ◽

pp. e035413

Author(s):

Petros Ismailidis ◽

Peter Kvarda ◽

Werner Vach ◽

Christian Appenzeller-Herzog ◽

Annegret Mündermann

Keyword(s):

Muscle Strength ◽

Hip Osteoarthritis ◽

Publication Date ◽

Review Author ◽

Sufficient Information ◽

Cochrane Central Register ◽

Abductor Muscle ◽

Total Hip ◽

Hip Abductor ◽

Abductor Strength

IntroductionConservation of abductor muscle strength is directly associated with physical function after total hip replacement (THA). Although many studies have tried to explore and quantify a potential abductor muscle strength deficit after THA as well as identify possible causes and treatment options, this topic has not been addressed systematically.Methods and analysisHuman-based studies reporting measurements of hip abductor strength will be included in this review. Studies reporting on hip abductor strength measured manually or isometric measurements at an abduction angle other than 0° will not be considered. No restriction will be placed on study design, publication date operative approach, prosthesis design, age and sex of the patients or severity of OA. Data sources will be Embase via embase.com, Medline ALL via Ovid and the Cochrane Central Register of Controlled Trials. The preliminary search was conducted on 5 May 2019. Data regarding absolute values or torque ratio of hip abductor torque between sides as well as patient demographic data, surgical approaches and rehabilitation protocols will be extracted. The assessment of quality and risk of bias will be performed with the modified Newcastle-Ottawa Scale. The screening, data extraction and quality assessment will be performed by two reviewers independently. Where necessary, a third review author will make a final judgement. Narrative synthesis as well as tabular presentation of the extracted data will be included. Whenever possible, metaregression and subgroup specific meta-analyses will be used to investigate the influence of time since THA and type of measurement (isokinetic or isometric) on the different outcomes. In case of sufficient information, these analyses will be extended to include characteristics such as age, sex, surgical approach or rehabilitation programme.Ethics and disseminationNo ethics approval is required. The results will be disseminated through peer-reviewed publications and conference presentations.PROSPERO registration numberCRD42020153185.

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The relationship between hip abductor muscle strength and iliotibial band tightness in individuals with low back pain

Chiropractic & Osteopathy ◽

10.1186/1746-1340-18-1 ◽

2010 ◽

Vol 18 (1) ◽

Cited By ~ 26

Author(s):

Amir M Arab ◽

Mohammad R Nourbakhsh

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Muscle Strength ◽

Iliotibial Band ◽

Low Back ◽

Abductor Muscle ◽

Hip Abductor ◽

The Relationship

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Individuals with diminished hip abductor muscle strength exhibit altered ankle biomechanics and neuromuscular activation during unipedal balance tasks

Gait & Posture ◽

10.1016/j.gaitpost.2013.12.004 ◽

2014 ◽

Vol 39 (3) ◽

pp. 933-938 ◽

Cited By ~ 18

Author(s):

Szu-Ping Lee ◽

Christopher M. Powers

Keyword(s):

Muscle Strength ◽

Abductor Muscle ◽

Neuromuscular Activation ◽

Hip Abductor ◽

Ankle Biomechanics

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Relationship between muscle strength and knee pain in knee osteoarthritis patients

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2014.02.782 ◽

2014 ◽

Vol 22 ◽

pp. S415

Author(s):

R. Fujita ◽

Y. Matsui ◽

A. Harada ◽

M. Takemura ◽

I. Kondo ◽

...

Keyword(s):

Muscle Strength ◽

Knee Osteoarthritis ◽

Knee Pain

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Effect of exercise therapy combined with branched-chain amino acid supplementation on muscle strengthening in persons with osteoarthritis

Hong Kong Physiotherapy Journal ◽

10.1142/s1013702518500038 ◽

2018 ◽

Vol 38 (01) ◽

pp. 23-31 ◽

Cited By ~ 5

Author(s):

Takashi Ikeda ◽

Tetsuya Jinno ◽

Tadashi Masuda ◽

Junya Aizawa ◽

Kazunari Ninomiya ◽

...

Keyword(s):

Amino Acid ◽

Muscle Strength ◽

Exercise Therapy ◽

Contralateral Side ◽

Elderly Persons ◽

Abductor Muscle ◽

Branched Chain Amino Acid ◽

Significant Difference ◽

Hip Abductor ◽

Branched Chain

Background: Improving lower limb muscle strength is important in preventing progression of osteoarthritis (OA) and its symptoms. Exercise with branched-chain amino acid (BCAA) supplementation has been reported to affect protein anabolism in young and elderly persons. However, few studies provided daily BCAAs for patients with OA. Objective: This study examined the effects of combined BCAAs and exercise therapy on physical function improvement in women with hip OA scheduled for total hip arthroplasty. Methods: The subjects were 43 women with OA (age: 64.2[Formula: see text][Formula: see text][Formula: see text]9.4). The participants were randomly divided into two groups: BCAA ([Formula: see text]) and control ([Formula: see text]). The combined therapy was carried out for one month. Exercise intervention involved hip abductor muscle exercise in both groups. For the nutritional intervention, 6[Formula: see text]g of BCAAs or 1.2[Formula: see text]g of starch were consumed within 10[Formula: see text]min before starting the exercise. Results: There was a marginally significant difference in the main effect between the groups in 10-m timed gait time. The improvement rate in hip abductor muscle strength of the contralateral side was significantly greater in the BCAA group. Conclusion: By combining BCAA intake and exercise therapy, a significant improvement in hip abductor muscle strength of the contralateral side was achieved in women with OA.

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