Relation of anterior pelvic tilt during running to clinical and kinematic measures of hip extension

The modified Thomas test was developed to assess the presence of hip flexion contracture and to measure hip extensibility. Despite its widespread use, to the authors’ knowledge, its criterion reference validity has not yet been investigated. The purpose of this study was to assess the criterion reference validity of the modified Thomas test for measuring peak hip extension angle and hip extension deficits, as defined by the hip not being able to extend to 0º, or neutral. Twenty-nine healthy college students (age = 22.00 ± 3.80 years; height = 1.71 ± 0.09 m; body mass = 70.00 ± 15.60 kg) were recruited for this study. Bland–Altman plots revealed poor validity for the modified Thomas test’s ability to measure hip extension, which could not be explained by differences in hip flexion ability alone. The modified Thomas test displayed a sensitivity of 31.82% (95% CI [13.86–54.87]) and a specificity of 57.14% (95% CI [18.41–90.10]) for testing hip extension deficits. It appears, however, that by controlling pelvic tilt, much of this variance can be accounted for (r= 0.98). When pelvic tilt is not controlled, the modified Thomas test displays poor criterion reference validity and, as per previous studies, poor reliability. However, when pelvic tilt is controlled, the modified Thomas test appears to be a valid test for evaluating peak hip extension angle.

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Comparison of sagittal spinal curvatures and pelvic tilt in highly trained athletes from different sport disciplines

Kinesiology ◽

10.26582/k.49.1.2 ◽

2017 ◽

Vol 49 (1) ◽

pp. 109-116 ◽

Cited By ~ 5

Author(s):

Pedro A. López-Miñarro ◽

Jose M. Muyor

Keyword(s):

Thoracic Kyphosis ◽

Pelvic Tilt ◽

Trunk Flexion ◽

Young Athletes ◽

Spinal Curvatures ◽

Tennis Players ◽

Sport Training ◽

Anterior Pelvic Tilt

The aim of this study was to compare the thoracic and lumbar curvatures and pelvic tilt in relaxed standing and maximal trunk flexion among highly-trained young athletes from three different sports disciplines. Thirty-two male canoeists, 30 male kayakers and 24 male tennis players were recruited for the study. The Spinal Mouse® system was used to measure the thoracic and lumbar sagittal spinal curvatures and pelvic tilt in relaxed standing and maximal trunk flexion in sitting with flexed (McRae & Wright test) and extended knees (sit-and-reach test). Significant differences were found in maximal trunk flexion tests among athletes. Kayakers and canoeists showed increased anterior pelvic tilt compared to tennis players in the McRae & Wright (p<.01) and decreased posterior pelvic tilt in the sit-and-reach (p<.001) tests; however, canoeists had increased posterior pelvic tilt compared to kayakers in the sit-and-reach test (p<.01). Canoeists had increased thoracic kyphosis curvature compared to kayakers (p<.01) and tennis players (p<.001) in the sit-and-reach test. Spinal sagittal curvatures and pelvic tilt in relaxed standing did not show significant differences. In conclusion, specific sport training may be associated with adaptations in the sagittal spinal curvatures and pelvic tilt when maximal trunk flexion positions are performed.

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Static Ankle Dorsiflexion and Hip and Pelvis Kinematics During Forward Step-Down in Patients With Hip-Related Groin Pain

Journal of Sport Rehabilitation ◽

10.1123/jsr.2020-0140 ◽

2020 ◽

pp. 1-8

Author(s):

Stefanie N. Foster ◽

Michael D. Harris ◽

Mary K. Hastings ◽

Michael J. Mueller ◽

Gretchen B. Salsich ◽

...

Keyword(s):

Pelvic Tilt ◽

Groin Pain ◽

Medical Center ◽

Weight Bearing ◽

Academic Medical Center ◽

Ankle Dorsiflexion ◽

Future Research ◽

Cross Sectional ◽

Anterior Pelvic Tilt ◽

Step Down

Context: The authors hypothesized that in people with hip-related groin pain, less static ankle dorsiflexion could lead to compensatory hip adduction and contralateral pelvic drop during step-down. Ankle dorsiflexion may be a modifiable factor to improve ability in those with hip-related groin pain to decrease hip/pelvic motion during functional tasks and improve function. Objective: To determine whether smaller static ankle dorsiflexion angles were associated with altered ankle, hip, and pelvis kinematics during step-down in people with hip-related groin pain. Design: Cross-sectional Setting: Academic medical center. Patients: A total of 30 people with hip-related groin pain (12 males and 18 females; 28.7 [5.3] y) participated. Intervention: None. Main Outcome Measures: Weight-bearing static ankle dorsiflexion with knee flexed and knee extended were measured via digital inclinometer. Pelvis, hip, and ankle kinematics during forward step-down were measured via 3D motion capture. Static ankle dorsiflexion and kinematics were compared with bivariate correlations. Results: Smaller static ankle dorsiflexion angles were associated with smaller ankle dorsiflexion angles during the step-down for both the knee flexed and knee extended static measures. Among the total sample, smaller static ankle dorsiflexion angle with knee flexed was associated with greater anterior pelvic tilt and greater contralateral pelvic drop during the step-down. Among only those who did not require a lowered step for safety, smaller static ankle dorsiflexion angles with knee flexed and knee extended were associated with greater anterior pelvic tilt, greater contralateral pelvic drop, and greater hip flexion. Conclusions: Among those with hip-related groin pain, smaller static ankle dorsiflexion angles are associated with less ankle dorsiflexion motion and altered pelvis and hip kinematics during a step-down. Future research is needed to assess the effect of treating restricted ankle dorsiflexion on quality of motion and symptoms in patients with hip-related groin pain.

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Standardization of lateral pelvic radiograph is necessary to predict spinopelvic mobility accurately

The Bone & Joint Journal ◽

10.1302/0301-620x.102b7.bjj-2019-1548.r1 ◽

2020 ◽

Vol 102-B (7_Supple_B) ◽

pp. 41-46 ◽

Cited By ~ 1

Author(s):

Michael Ransone ◽

Keith Fehring ◽

Thomas Fehring

Keyword(s):

Pelvic Tilt ◽

Preoperative Planning ◽

Sacral Slope ◽

Sitting Posture ◽

Sit To Stand ◽

Pelvic Radiograph ◽

Increased Risk ◽

Anterior Pelvic Tilt ◽

B 41 ◽

The Mean

Aims Patients with abnormal spinopelvic mobility are at increased risk for instability. Measuring the change in sacral slope (ΔSS) can help determine spinopelvic mobility preoperatively. Sacral slope (SS) should decrease at least 10° to demonstrate adequate posterior pelvic tilt. There is potential for different ΔSS measurements in the same patient based on sitting posture. The purpose of this study was to determine the effect of sitting posture on the ΔSS in patients undergoing total hip arthroplasty (THA). Methods In total, 51 patients undergoing THA were reviewed to quantify the variability in preoperative spinopelvic mobility when measuring two different sitting positions using SS for planning. Results A total of 32 patients had standardized relaxed sitting radiographs, while 35 patients had standardized flexed sitting images. Of the 32 patients with relaxed sitting views, the mean ΔSS was 20.7° (SD 8.9°). No patients exhibited an increase in SS during relaxed sitting (i.e. anterior pelvic tilt or so-called reverse accommodation). Of the 35 patients with flexed sitting radiographs, the mean ΔSS was only 2.1° (SD 9.7°) with 16/35 (45.71%) showing anterior pelvic tilt, or so-called reverse accommodation, unexpectedly increasing the sitting SS compared to the standing SS. Overall, 18 patients had both relaxed sitting and flexed sitting radiographs. In patients with both types of sitting radiographs, the mean relaxed sit to stand ΔSS was 18.06° (SD 6.07°), while only a 3.00° (SD 10.53°) ΔSS was noted when flexed sitting. There was a mean ΔSS difference of 15.06° (SD 7.67°) noted in the same patient cohort depending on sitting posture (p < 0.001). Conclusion A 15° mean difference was noted depending on the sitting posture of the patient. Since decisions on component position can be made on preoperative lateral sit-stand radiographs, postural standardization is crucial. If using ΔSS for preoperative planning, the relaxed sitting radiograph is preferred. Cite this article: Bone Joint J 2020;102-B(7 Supple B):41–46.

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