Prone vs Supine Positioning for Femoral Derotation Osteotomy: Kinematic and Physical Examination Outcomes Suggest Both Can Achieve Desired Results

2021 ◽  
pp. 155633162199706
Author(s):  
Uri Givon ◽  
Lisa Drefus ◽  
Mary Murray-Weir ◽  
Mark Lenhoff ◽  
Jayme C. Burket-Koltsov ◽  
...  
Keyword(s):  
Supine Position ◽  
Primary Outcome ◽  
Patient Positioning ◽  
Knee Extension ◽  
Hip Abduction ◽  
Spatial Parameters ◽  
Derotation Osteotomy ◽  
Hip Rotation ◽  
Hip Extension ◽  
Gmfcs Level

Background: Femoral derotation osteotomy (FDO) for correction of internal rotation gait resulting from cerebral palsy (CP) can be performed with the patient in the prone or supine position. It is not known whether patient positioning during FDO affects the change in hip rotation. Purpose/Questions: We sought to compare the change in hip rotation following FDO performed on patients with CP in the prone or supine position through kinematic analysis. Methods: We conducted a consecutive retrospective cohort study of children with CP, ages 3 to 18 years and with Gross Motor Function Classification System (GMFCS) levels I to III, who underwent prone or supine FDO and pre- and postoperative motion analysis. The prone group included 37 patients (68 limbs) between 1990 and 1995. The supine group included 26 patients (47 limbs) between 2005 and 2015. The groups were matched for gender, age, and GMFCS level. The primary outcome was hip rotation in degrees during stance phase. Secondary outcomes included temporal-spatial parameters, hip abduction, hip and knee extension, and hip and knee passive range of motion (ROM). Results: The prone group had more bilateral patients (100%) than the supine group (81%). The supine group underwent more concomitant procedures. There was no difference between the prone and supine groups in postoperative stance hip rotation; both groups had significantly improved stance hip rotation, step width, and hip rotation passive ROM, pre- to postoperatively. Prone patients had improved postoperative hip extension, pelvic tilt, velocity, and cadence. Conclusions: There was no significant different in stance hip rotation between supine and prone FDO groups. Advocates of prone positioning for FDO suggest it allows more accurate assessment of rotation. Supine positioning may be more convenient when additional procedures are required. Based on our findings, either approach can achieve the desired result.

scholarly journals Development of an on-field injury screening test using wearable sensor technology

2020 ◽  
Vol 8 (9_suppl7) ◽  
pp. 2325967120S0051
Author(s):  
Pinar Melodi Caliskan ◽  
Anne Benjaminse ◽  
Alli Gokeler
Keyword(s):  
Knee Flexion ◽  
Motor Coordination ◽  
Knee Extension ◽  
Ankle Dorsiflexion ◽  
Hip Abduction ◽  
Knee Abduction ◽  
Hip Flexion ◽  
Injury Screening ◽  
Coordination Patterns ◽  
Hip Extension

Introduction: Injuries of the anterior cruciate ligament (ACL) commonly occur during complex game situations when the athlete encounters multiple factors such as ball, opponent, field position, and game strategy (Grooms et al., 2018). Many of the current traditional injury screening programs are performed within a predictable, fixed or ‘closed’ environment which do not represent real game situations that require high neurocognitive demands (Dingenen & Gokeler, 2017; Grooms et al., 2018). A complementary approach to lab-based settings is necessary to incorporate the demands of the complex athletic environments. By using wearable sensor technology, we aim to develop an on-field injury screening test in elite youth male soccer players. Investigating the individual differences in motor coordination patterns of the players during sport-specific tasks might enhance our understanding of how ACL injuries occur. Hypotheses: We hypothesized that the motor coordination patterns of the players would be affected when they perform under different conditions manipulated with constraints (task and environmental). Methods: A football-specific test setup was created to analyse the kinematic and performance measures of a group of 17 male youth elite football players aged 15 years (height = 164 ± 9 cm, mass = 50.9± 7.4 kg). The players were grouped into two and measured on two consecutive days. All the players were instructed to complete the test setup (4 conditions, 5 trials) as fast as possible. Condition 1 includes no constraint, condition 2 includes a task constraint (football dummies), condition 3 includes an environmental constraint (stroboscopic glasses) (SENAPTEC, Beaverton, Oregon) and condition 4 includes both task and environmental constraints. 3-D kinematics of the hip, knee, ankle joints were captured using Xsens wearable full-body sensor suits (Xsens, MVN Link version, Enschede, The Netherlands). MATLAB (MATLAB R2019a, The MathWorks Inc., Massachusetts) was used to process and analyse the kinematic data. Data from condition 1 was determined as reference behavior/condition to be compared to other conditions. Kinematic data are presented in attitude vectors (ATV). Results: In total, 81% of the players demonstrated a significant difference (P < 0.05) in angles of hip, knee and ankle joints when performing under different conditions. The percentage of players with increased comparison-based joint movements as follows; condition 1 to condition 2 comparison; 41% hip flexion, 59% hip extension, 53% hip abduction, 47% hip adduction, 62% knee flexion, 38% knee extension, 59% knee abduction, 41% knee adduction, 47% ankle dorsiflexion, 53% ankle plantarflexion, condition 1 to condition 3 comparison; 35% hip flexion, 65% hip extension, 47% hip abduction, 53% hip adduction, 50% knee flexion, 50% knee extension, 41% knee abduction, 59% knee adduction, 59% ankle dorsiflexion, 41% ankle plantarflexion and condition 1 to condition 4 comparison; 31% hip flexion, 69% hip extension, 38% hip abduction, 62% hip adduction, 60% knee flexion, 40% knee extension, 44% knee abduction, 56% knee adduction, 69% ankle dorsiflexion, 31% ankle plantarflexion. Conclusion: The result of this pilot study demonstrated that manipulating task with different constraints caused significant changes in players’ motor coordination patterns which supported the hypothesis of our study. Our findings suggest to develop ACL injury screening tests in a sport-specific setting.

scholarly journals Exercise Prescription for a Patient 3 Months After Hip Fracture

2005 ◽  
Vol 85 (7) ◽  
pp. 676-687 ◽  
Author(s):  
Kathleen K Mangione ◽  
Kerstin M Palombaro
Keyword(s):  
Hip Fracture ◽  
Lower Extremity ◽  
Physical Therapist ◽  
Knee Extension ◽  
Functional Activities ◽  
Balance Confidence ◽  
Program Outcome ◽  
Strengthening Exercises ◽  
Hip Abduction ◽  
Hip Extension

Abstract Background and Purpose. Most patients with hip fracture do not return to prefracture functional status 1 year after surgery. The literature describing interventions, however, does not use classic overload and specificity principles. The purpose of this case report is to describe the use of resistance training to improve functional outcomes in a patient following hip fracture. Case Description. The patient was a 68-year-old woman who had a comminuted intertrochanteric fracture of the left hip 3 months previously. She used a cane for ambulation, and her walking was limited. The patient received 16 sessions of lower-extremity strengthening exercises, aerobic training on a stationary bicycle, functional training supervised by a physical therapist, and a home stretching program. Outcome. The patient's isometric muscle force for involved hip extension, hip abduction, and knee extension improved by 86%, 138%, and 33%, respectively; walking endurance increased by 22.5%; balance improved by 400%; balance confidence increased by 41%; and self-reported ability to perform lower-extremity functional activities increased by 20%. Discussion. The authors believe that some patients can perform comprehensive exercise programs after hip fracture and that properly designed programs can affect patient outcomes beyond observed impairments.

Effects of hip rotation on the electromyographic activity of the medial and lateral hamstrings and muscle force

2021 ◽  
pp. 1-7
Author(s):  
Wootaek Lim
Keyword(s):  
Prone Position ◽  
Supine Position ◽  
Knee Flexion ◽  
External Rotation ◽  
Emg Activity ◽  
Electromyographic Activity ◽  
Hamstring Muscles ◽  
Extension Force ◽  
Hip Rotation ◽  
Hip Extension

BACKGROUND: In clinical practice, knee flexion at the prone position for manual muscle testing of hamstrings and hip extension at the supine position for stretching of hamstring muscles are typically proposed. OBJECTIVE: Although different positions have been proposed for different purposes in hamstrings, the understanding of the changing the functional role of hamstrings with position changes is poorly understood. METHODS: The electromyographic (EMG) activity and hip extension force were compared among different postures; hip neutral, internal, and external rotation. EMG and force were measured in prone position during knee flexion and those were additionally measured in supine position during hip extension. In supine position, additional measurements were made in hip neutral, internal and external rotation. RESULTS: Hamstrings showed high EMG activity during knee flexion. Knee flexion force in prone position was significantly decreased at hip extension force in supine position. In supine position, EMG activity was significantly higher in semitendinosus (ST) than biceps femoris (BF) during internal rotation. CONCLUSIONS: It should be noted that bi-articular muscles may have different functional dependencies on the corresponding muscles for each joint. In addition, because the altered alignment of the hamstring muscles that was affected by hip rotation had a significant effect on muscle activity, and hip rotation may be helpful for selective training of medial or lateral hamstrings.

scholarly journals Are isokinetic leg torques and kick velocity reliable predictors of competitive level in taekwondo athletes?

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0235582
Author(s):  
Pedro Vieira Sarmet Moreira ◽  
Coral Falco ◽  
Luciano Luporini Menegaldo ◽  
Márcio Fagundes Goethel ◽  
Leandro Vinhas de Paula ◽  
...  
Keyword(s):  
Peak Torque ◽  
Knee Extension ◽  
Linear Velocity ◽  
Group Differences ◽  
Linear Discriminant ◽  
Hip Muscle ◽  
Hip Abduction ◽  
Expertise Level ◽  
Hip Flexion ◽  
Hip Extension

The aim of this study is to analyze how isokinetic knee and hip peak torques and roundhouse kick velocities are related to expertise level (elite vs. sub-elite) in taekwondo athletes. Seven elite and seven sub-elite athletes were tested for kick-specific variables (KSV, composed of kinematic variables and power of impact) and for concentric isokinetic peak torque (PT) at 60°/s and 240°/s. First, KSVs and PTs were compared between groups, then PTs were correlated with KSVs. Parametric variables with larger effect sizes (Cohen’s d) were entered in a stepwise linear discriminant analysis (LDA), generating an equation to estimate competitive level. Between-group differences were found in hip flexors (p = 0.04, d = 0.92) and extensors (p = 0.04, d = 0.96) with PT at 240°/s. Hip flexion PT at 60°/s and 240°/s correlated negatively with kick time (R = –0.46, p = 0.0499 and R = –0.62, p = 0.01 respectively). Hip flexion torque at 60°/s correlated positively (R = 0.52, p = 0.03) with peak linear velocity of the foot (LVF) and power of impact (R = 0.51, p = 0.03). Peak torque of hip extension at 60°/s and hip abduction at 240°/s also correlated with LVF (R = 0.56, p = 0.02 and R = 0.46, p = 0.0499). Hip extension at 60°/s correlated positively with peak linear velocity of the knee (R = 0.48, p = 0.04). The LDA showed an accuracy of 85.7% (p = 0.003) in predicting expertise level based on hip flexion and extension torques at 240°/s and on knee extension velocity during the kick. The study demonstrates that hip muscle strength is probably the dominant muscular factor for determining kick performance. Knee angular velocity combined with hip torques is the best discriminator for competitive level in taekwondo athletes.

scholarly journals Are isokinetic leg torques and kick velocity reliable predictors for competitive success in taekwondo athletes?

2020 ◽  
Author(s):  
Pedro Vieira Sarmet Moreira ◽  
Coral Falco ◽  
Luciano Luporini Menegaldo ◽  
Márcio Fagundes Goethel ◽  
Leandro Vinhas de Paula ◽  
...  
Keyword(s):  
Peak Torque ◽  
Knee Extension ◽  
Group Differences ◽  
Hip Abduction ◽  
Competitive Success ◽  
Expertise Level ◽  
Hip Flexion ◽  
The Relationship ◽  
Hip Extension ◽  
Flexion And Extension

AbstractThe aim of the study was to analyzed the relationship between isokinetic knee and hip peak torques and Roundhouse-kick velocities and expertise level (Elite vs. Subelite) of Taekwondo athletes. Seven elite and seven sub-elite athletes were tested for kick kinematic, power of impact and for isokinetic peak torque (PT) at slow (60°/s) and high (240°/s) concentric mode. PTs were compared between groups and correlated with the data of kick performance. It was found inter-group differences in hip flexors and extensors PT at the isokinetic fast speed. The hip flexion PT at 60°/s and 240°/s were negatively correlated with the kick time (R = −0.46, and R = −0.62, respectively). Hip flexion torque at 60°/s was also positively correlated (R = 0.52) with the peak of linear velocity of the foot (LVF) and the power of impact (R = 0.51). Peak torque of hip extension at 60°/s and hip abduction at 240°/s were correlated with the LVF (R= 0.56 and R = 0.46). Discriminant analysis presented an accuracy of 85.7% in predicting expertise level based on fast torques of hip flexion and extension and on the knee extension velocity during the kick. This study demonstrated that hip muscles strength is probably the dominant muscular factor for determining kick performance. Knee angular velocity combined with hip torques are the best discriminators for the competitive level in taekwondo athletes.

The Effect of Increasing Jump Steps on Stance Leg Joint Kinetics in Bounding

2018 ◽  
Vol 39 (09) ◽  
pp. 661-667 ◽  
Author(s):  
Yasushi Kariyama ◽  
Hiroaki Hobara ◽  
Koji Zushi
Keyword(s):  
Plantar Flexion ◽  
Standing Position ◽  
Knee Extension ◽  
Joint Work ◽  
Joint Power ◽  
Male Athletes ◽  
Joint Kinetics ◽  
Jump Distance ◽  
Hip Abduction ◽  
Hip Extension

AbstractJump distance per step in bounding exercises from the standing position increases with increasing number of steps. We examined the hypothesis that the joint kinetic variables of the stance leg would also increase accordingly. Eleven male athletes (sprinters and jumpers) performed bounding exercise, starting from the double-leg standing posture, and covered the longest distance possible by performing a series of seven forward alternating single-leg jumps. Kinematic and kinetic data were calculated using the data by a motion capture system and force platforms. Hip extension joint work were decreased at third step (1st: 1.07±0.22, 3rd: 0.45±0.15, 5th: 0.47±0.14 J•kg−1; partial η2: 0.86), and hip abduction joint power were increased (1st: 7.53±3.29, 3rd: 13.50±4.44, 5th: 21.37±9.93 W•kg−1; partial η2: 0.58); the knee extension joint power were increased until the third step (1st: 14.43±4.94, 3rd: 17.13±3.59, 5th: 14.28±2.86 W•kg−1; partial η2: 0.29), and ankle plantar flexion joint power increased (1st: 34.14±5.33, 3rd: 37.46±4.45, 5th: 40.11±5.66 W•kg−1; partial η2: 0.53). These results contrast with our hypothesis, and indicate that increasing the jump distance during bounding exercises is not necessarily accompanied by increases in joint kinetics of stance leg. Moreover, changes in joint kinetics vary at different joints and anatomical axes.

Legal Update: North Dakota Supreme Court: Third Edition of Guides is “Most Current”

1999 ◽  
Vol 4 (1) ◽  
pp. 6-7
Author(s):  
James J. Mangraviti
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Measurement Techniques ◽  
Fourth Edition ◽  
Hip Motion ◽  
The Difference ◽  
The Right ◽  
Hip Flexion ◽  
Hip Rotation ◽  
Hip Extension

Abstract The accurate measurement of hip motion is critical when one rates impairments of this joint, makes an initial diagnosis, assesses progression over time, and evaluates treatment outcome. The hip permits all motions typical of a ball-and-socket joint. The hip sacrifices some motion but gains stability and strength. Figures 52 to 54 in AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, illustrate techniques for measuring hip flexion, loss of extension, abduction, adduction, and external and internal rotation. Figure 53 in the AMA Guides, Fourth Edition, illustrates neutral, abducted, and adducted positions of the hip and proper alignment of the goniometer arms, and Figure 52 illustrates use of a goniometer to measure flexion of the right hip. In terms of impairment rating, hip extension (at least any beyond neutral) is irrelevant, and the AMA Guides contains no figures describing its measurement. Figure 54, Measuring Internal and External Hip Rotation, demonstrates proper positioning and measurement techniques for rotary movements of this joint. The difference between measured and actual hip rotation probably is minimal and is irrelevant for impairment rating. The normal internal rotation varies from 30° to 40°, and the external rotation ranges from 40° to 60°.

scholarly journals Validity and reliability of smartphone applications for measurement of hip rotation, compared with three‐dimensional motion analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Phob Ganokroj ◽  
Nuchanun Sompornpanich ◽  
Pichitpol Kerdsomnuek ◽  
Bavornrat Vanadurongwan ◽  
Pisit Lertwanich
Keyword(s):  
Internal Rotation ◽  
Motion Analysis ◽  
Supine Position ◽  
External Rotation ◽  
Three Dimensional ◽  
Angle Measurement ◽  
Smartphone Applications ◽  
Rater Reliability ◽  
Link Type ◽  
Hip Rotation

Abstract Background Measurement of hip rotation is a crucial clinical parameter for the identification of hip problems and the monitoring of symptoms. The objective of this study was to determine whether the use of two smartphone applications is valid and reliable for the measurement of hip rotation. Methods An experimental, cross-sectional study was undertaken to assess passive hip internal and external rotation in three positions by two examiners. The hip rotational angles were measured by a smartphone clinometer application in the sitting and prone positions, and by a smartphone compass application in the supine position; their results were compared with those of the standard, three-dimensional, motion analysis system. The validities and inter-rater and intra-rater reliabilities of the smartphone applications were evaluated. Results The study involved 24 participants. The validities were good to excellent for the internal rotation angles in all positions (ICC 0.81–0.94), good for the external rotation angles in the prone position (ICC 0.79), and fair for the sitting and supine positions (ICC 0.70–0.73). The measurement of the hip internal rotation in the supine position had the highest ICC value of 0.94 (0.91, 0.96). The two smartphone applications showed good-to-excellent intra-rater reliability, but good-to-excellent inter-rater reliability for only three of the six positions (two other positions had fair reliability, while one position demonstrated poor reliability). Conclusions The two smartphone applications have good-to-excellent validity and intra-rater reliability, but only fair-to-good inter-rater reliability for the measurement of the hip rotational angle. The most valid hip rotational position in this study was the supine IR angle measurement, while the lowest validity was the ER angle measurement in the sitting position. The smartphone application is one of the practical measurements in hip rotational angles. Trial registration Number 20181022003 at the Thai Clinical Trials Registry (http://www.clinicaltrials.in.th) which was retrospectively registered at 2018-10-18 15:30:29.

scholarly journals Reliability of a New Portable Dynamometer for Assessing Hip and Lower Limb Strength

2021 ◽  
Vol 11 (8) ◽  
pp. 3391
Author(s):  
Jan Marušič ◽  
Goran Marković ◽  
Nejc Šarabon
Keyword(s):  
Lower Limb ◽  
External Rotation ◽  
Peak Torque ◽  
Knee Extension ◽  
Lower Limb Muscles ◽  
Lower Limb Strength ◽  
Flexion Extension ◽  
Strength Tests ◽  
Hip Abduction ◽  
Maximal Peak

The purpose of this study was to evaluate intra- and inter-session reliability of the new, portable, and externally fixated dynamometer called MuscleBoard® for assessing the strength of hip and lower limb muscles. Hip abduction, adduction, flexion, extension, internal and external rotation, knee extension, ankle plantarflexion, and Nordic hamstring exercise strength were measured in three sessions (three sets of three repetitions for each test) on 24 healthy and recreationally active participants. Average and maximal value of normalized peak torque (Nm/kg) from three repetitions in each set and agonist:antagonist ratios (%) were statistically analyzed; the coefficient of variation and intra-class correlation coefficient (ICC2,k) were calculated to assess absolute and relative reliability, respectively. Overall, the results display high to excellent intra- and inter-session reliability with low to acceptable within-individual variation for average and maximal peak torques in all bilateral strength tests, while the reliability of unilateral strength tests was moderate to good. Our findings indicate that using the MuscleBoard® dynamometer can be a reliable device for assessing and monitoring bilateral and certain unilateral hip and lower limb muscle strength, while some unilateral strength tests require some refinement and more extensive familiarization.

scholarly journals Musculoskeletal Outcomes from Chronic High-Speed, High-Impulse Resistance Exercise

2018 ◽  
Vol 39 (10) ◽  
pp. 791-801 ◽  
Author(s):  
John Caruso ◽  
Michael Voor ◽  
Jason Jaggers ◽  
T. Symons ◽  
Jeremy Stith ◽  
...  
Keyword(s):  
Mechanical Loading ◽  
High Speed ◽  
Type I Collagen ◽  
Training Session ◽  
Knee Extension ◽  
Type I ◽  
Before And After ◽  
Force Peak ◽  
Blood Marker ◽  
Hip Extension

AbstractWhile bones and muscles adapt to mechanical loading, it appears that very specific types of stimuli must be applied to achieve osteogenesis. Our study assessed musculoskeletal outcomes to 30 training sessions on an Inertial Exercise Trainer (Newnan, GA). Subjects (n=13) performed workouts with their left leg, while their right served as an untreated control. Workouts entailed three 60-s sets each of knee extension, hip extension and calf press exercises, separated by 90-s rests. Before and after the 30 training sessions, subjects underwent strength tests (knee and ankle extensors of both legs), DEXA scans (hip, knee and ankles of both legs), and blood draws. After 30 training sessions 2×2 ANOVAs showed left leg peak torques rose significantly. 2×2 ANCOVAs, with bone scan area as a covariate, showed significant left leg calcaneal bone mineral content (+29%) and density (+33%) increases after 30 training sessions. A significant decline in C-terminal telopeptides of type I collagen, a blood marker of bone resorption, also occurred after 30 training sessions. The Inertial Exercise Trainer’s large volume of training session repetitions elicited high peak force, peak acceleration and impulses that likely provided a mechanical loading stimulus that evoked calcaneal accretion.

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