Hip Flexion Position Influences Hip Extension And External Rotation Torque Measurements

2015 ◽  
Vol 47 ◽  
pp. 211
Author(s):  
Tyler N. Tylinski ◽  
Jay Sparks ◽  
Jelena Krstic ◽  
Abigail Stromquist ◽  
David M. Bazett-Jones
Keyword(s):  
External Rotation ◽  
Torque Measurements ◽  
Hip Flexion ◽  
Hip Extension

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°.

The Influence of Sagittal Plane Hip Position on Lower-Extremity Muscle Activity and Torque Output

2020 ◽  
pp. 1-9
Author(s):  
Neal R. Glaviano ◽  
David M. Bazett-Jones
Keyword(s):  
Muscle Activity ◽  
Sagittal Plane ◽  
External Rotation ◽  
Gluteus Maximus ◽  
Muscle Testing ◽  
Lower Extremity Muscle ◽  
Hip Muscle ◽  
Hip Flexion ◽  
Hip Extension ◽  
Adductor Longus

Context: Hip muscle strength has previously been evaluated in various sagittal plane testing positions. Altering the testing position appears to have an influence on hip muscle torque during hip extension, abduction, and external rotation. However, it is unknown how altering the testing position influences hip muscle activity during these commonly performed assessments. Objectives: To evaluate how hip sagittal plane position influences hip muscle activation and torque output. Study Design: Cross-sectional. Setting: Laboratory. Patients or Other Participants: A total of 22 healthy females (age = 22.1 [1.4] y; mass = 63.4 [11.3] kg; height = 168.4 [6.2] cm) were recruited. Intervention: None. Main Outcome Measures: Participants completed isometric contractions with surface electromyography on the superior and inferior gluteus maximus; anterior, middle, and posterior gluteus medius; biceps femoris, semitendinosus, adductor longus, and tensor fascia latae. Extension and external rotation were tested in 0°, 45°, and 90° of hip flexion and abduction was tested in −5°, 0°, and 45° of hip flexion. Repeated-measures analysis of variances were used for statistical analysis (P ≤ .01). Results: Activation of gluteal (P < .007), semitendinosus (P = .002), and adductor longus (P = .001) muscles were lesser for extension at 90° versus less flexed positions. Adductor longus activity was greatest during 90° of hip flexion for external rotation torque testing (P < .001). Tensor fascia latae (P < .001) and gluteus maximus (P < .001) activities were greater in 45° of hip flexion. Significant differences in extension (P < .001) and abduction (P < .001) torque were found among positions. Conclusions: Position when assessing hip extension and abduction torque has an influence on both muscle activity and torque output but only muscle activity for hip external rotation torque. Clinicians should be aware of the influence of position on hip extension, abduction, and external rotation muscle testing and select a position most in line with their clinical goals.

Functional Hip Characteristics and Their Relationship With Ball Velocity in College Baseball Pitchers

2019 ◽  
Vol 28 (8) ◽  
pp. 854-859
Author(s):  
Osamu Yanagisawa ◽  
Kenta Wakamatsu ◽  
Hidenori Taniguchi
Keyword(s):  
Muscle Strength ◽  
Internal Rotation ◽  
External Rotation ◽  
Hip Muscle ◽  
Flexion Extension ◽  
Ball Velocity ◽  
College Baseball ◽  
Baseball Pitchers ◽  
Hip Flexion ◽  
Hip Extension

Context: Compared to shoulder and elbow functions, the hip functional characteristics of baseball pitchers have not been fully investigated. Therefore, little is known about the relationship between hip function and pitching performance. Objective: The purpose of this study was to evaluate the characteristics of hip flexibility and strength, focusing on their influences on the ball velocity in baseball pitchers. Design: Descriptive laboratory study. Setting: Laboratory and university baseball facility. Participants: Twenty-three college baseball pitchers. Interventions: Passive hip range of motion (ROM) and isometric hip muscle strength were bilaterally measured. The pitchers threw 20 fastballs at an official pitching distance. Main Outcome Measures: Bilateral hip ROM and strength in flexion, extension, abduction, adduction, and external and internal rotation; the maximal ball velocity. Results: The pivot side showed smaller hip external rotation ROM (P < .01), larger hip internal rotation ROM (P = .03), and greater hip adduction strength (P = .03) than the stride side. The hip extension ROM on the stride side had a negative correlation with the maximal ball velocity (r = −.58, P < .01). The maximal ball velocity (135.3 [4.1] km/h) positively correlated with the hip extension (r = .59, P < .01), flexion (r = .57, P < .01), abduction (r = .55, P < .01), and adduction (r = .55, P < .01) strength on the pivot leg, and the hip flexion (r = .53, P = .01), abduction (r = .67, P < .01), and adduction (r = .46, P = .03) strength on the stride leg. Conclusions: These findings suggest that baseball pitchers do not have marked side-to-side differences in hip flexibility and strength, and that an important fitness factor for increasing ball velocity is not the hip flexibility but the hip muscle strength of both legs.

scholarly journals Increased Range of Motion and Function in an Individual with Breast Cancer and Necrotizing Fasciitis—Manual Therapy and Pulsed Short-Wave Diathermy Treatment

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Wayne Johnson ◽  
David O. Draper
Keyword(s):  
Breast Cancer ◽  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Manual Therapy ◽  
External Rotation ◽  
Subcutaneous Tissue ◽  
Short Wave ◽  
Surgical Debridement ◽  
Hip Flexion ◽  
Hip Extension

Necrotizing fasciitis is a severe soft tissue infection of the subcutaneous tissue and fascia affecting those predisposed to immune system compromise. It is a life threatening condition; mortality can be reduced by rapid diagnosis, adequate early surgical debridement and antibiotic ointment. In this case report we present the use of manual therapy (MT) techniques, joint and soft tissue mobilization, following a regimen of pulsed short wave diathermy (PSWD) in the treatment of a woman 3 years post necrotizing fasciitis developed during chemotherapy treatment for breast cancer. During her course of chemotherapy, she developed necrotizing fasciitis which was treated with extensive surgical debridement (8 linear feet of incisions) followed by debridement to both hips and the pelvis area. When we started working with her, we put her on a course of PSWD/MT. After six weeks of following this regimen, she gained of external rotation in both her left and right hips, of left hip flexion and of right hip flexion. The patient gained of right hip extension, yet there was no improvement in left hip extension. The treatments led to a dramatic reduction in pain and scarring from previous surgeries. The patient also returned to running.

scholarly journals Gender Differences in Kinematic Analysis of the Lower Limbs during the Chasse Step in Table Tennis Athletes

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 703
Author(s):  
Xiaoyi Yang ◽  
Yuqi He ◽  
Shirui Shao ◽  
Julien S. Baker ◽  
Bíró István ◽  
...  
Keyword(s):  
Female Athletes ◽  
External Rotation ◽  
Rotational Velocity ◽  
Knee Extension ◽  
Lower Limbs ◽  
Table Tennis ◽  
Male Athletes ◽  
Analysis System ◽  
Hip Flexion ◽  
Hip Internal Rotation

The chasse step is one of the most important footwork maneuvers used in table tennis. The purpose of this study was to investigate the lower limb kinematic differences of table tennis athletes of different genders when using the chasse step. The 3D VICON motion analysis system was used to capture related kinematics data. The main finding of this study was that the step times for male athletes (MA) were shorter in the backward phase (BP) and significantly longer in the forward phase (FP) than for female athletes (FA) during the chasse step. Compared with FA, knee external rotation for MA was larger during the BP. MA showed a smaller knee flexion range of motion (ROM) in the BP and larger knee extension ROM in the FP. Moreover, hip flexion and adduction for MA were significantly greater than for FA. In the FP, the internal rotational velocity of the hip joint was significantly greater. MA showed larger hip internal rotation ROM in the FP but smaller hip external rotation ROM in the BP. The differences between genders can help coaches personalize their training programs and improve the performance of both male and female table tennis athletes.

scholarly journals Comparison of short-term outcomes of anterolateral supine approach and posterolateral approach for primary total hip arthroplasty: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Taku Ukai ◽  
Goro Ebihara ◽  
Masahiko Watanabe
Keyword(s):  
Total Hip Arthroplasty ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
External Rotation ◽  
Posterolateral Approach ◽  
Level Of Evidence ◽  
Total Hip ◽  
Hip Flexion ◽  
Primary Total Hip Arthroplasty

Abstract Background This study aims to evaluate postoperative pain and functional and clinical outcomes of anterolateral supine (ALS) and posterolateral (PL) approaches for primary total hip arthroplasty. Materials and methods We retrospectively examined the joints of 110 patients who underwent primary total hip arthroplasty (THA). The ALS group was compared with the PL group using the pain visual analog scale (VAS) and narcotic consumption as pain outcomes. Functional outcomes included postoperative range of motion (ROM) of hip flexion, day on which patients could perform straight leg raising (SLR), day on which patients began using a walker or cane, duration of hospital stay, rate of transfer, and strength of hip muscles. Clinical outcomes included pre and postoperative Harris Hip Scores. Results No significant differences were found in the pain VAS scores or narcotic consumption between the two groups. The PL group could perform SLR earlier than the ALS group (P < 0.01). The ALS group started using a cane earlier (P < 0.01) and had a shorter hospital stay (P < 0.01) than the PL group. Degrees of active ROM of flexion at postoperative day (POD) 1 were significantly lower in the ALS group than in the PL group (P < 0.01). Regarding hip muscle strength, hip flexion was significantly weaker in the ALS group than in the PL group until 1-month POD (P < 0.01). External rotation from 2 weeks to 6 months postoperatively was significantly weaker in the PL group than in the ALS group (P < 0.01). Conclusion The ALS approach was more beneficial than the PL approach because ALS enabled better functional recovery of the strength of external rotation, improved rehabilitation, and involved a shorter hospital stay. Level of Evidence Level IV retrospective observational study.

scholarly journals The modified Thomas test is not a valid measure of hip extension unless pelvic tilt is controlled

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2325 ◽  
Author(s):  
Andrew D. Vigotsky ◽  
Gregory J. Lehman ◽  
Chris Beardsley ◽  
Bret Contreras ◽  
Bryan Chung ◽  
...  
Keyword(s):  
College Students ◽  
Body Mass ◽  
Pelvic Tilt ◽  
Flexion Contracture ◽  
Valid Measure ◽  
Valid Test ◽  
Hip Flexion ◽  
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.

scholarly journals The Biomechanical Consequences of Arthroscopic Hip Capsulotomy and Repair in Positions at Risk for Dislocation

2022 ◽  
Vol 10 (1) ◽  
pp. 232596712110616
Author(s):  
Amanda Wach ◽  
Ryan Mlynarek ◽  
Suzanne A. Maher ◽  
Bryan T. Kelly ◽  
Anil Ranawat
Keyword(s):  
At Risk ◽  
High Risk ◽  
External Rotation ◽  
Estimating Equation ◽  
Anterior Dislocation ◽  
Equation Modeling ◽  
Biaxial Test ◽  
Resistive Torque ◽  
Secondary Hypothesis ◽  
Hip Flexion

Background: The effect of interportal (IP) capsulotomy, short T-capsulotomy, and long T-capsulotomy, and their repairs, on resistance to anterior and posterior “at risk for dislocation” positions has not been quantified. Hypotheses: Our primary hypothesis was that an IP capsulotomy would have a minimal effect on hip resistive torque compared with both short and long T-capsulotomies in the at-risk dislocation positions. Our secondary hypothesis was that capsule repair would significantly increase hip resistive torque for all capsulotomies. Study Design Controlled laboratory study. Methods: We mounted 10 cadaveric hips on a biaxial test frame in an anterior dislocation high-risk position (20° of hip extension and external rotation) and posterior dislocation high-risk position (90° of hip flexion and internal rotation). An axial force of 100 N was applied to the intact hip while the femur was internally or externally rotated at 15° per second to a torque of 5 N·m. The rotatory position at 5 N·m was recorded and set as a target for each subsequent condition. Hips were then sequentially tested with IP, short T-, and long T-capsulotomies and with corresponding repairs randomized within each condition. Peak resistive torques were compared using generalized estimating equation modeling and post hoc Bonferroni-adjusted tests. Results: For the anterior position, the IP and long T-capsulotomies demonstrated significantly lower resistive torques compared with intact. For the posterior position, both the short and long T-capsulotomies resulted in significantly lower resistive torques compared with intact. Repairs for all 3 capsulotomy types were not significantly different from the intact condition at anterior and posterior positions. Conclusion: An IP incision resulted in a decrease in capsular resistive torque in the anterior but not the posterior at-risk dislocation position, in which direction only T-capsulotomies led to a significant decrease. All capsulotomy repair conditions resulted in hip resistive torques that were similar to the intact hip in both dislocation positions. Clinical Relevance Our results suggest that it is biomechanically advantageous to repair IP, short T-, and long T-capsulotomies, particularly for at-risk anterior dislocation positions.

scholarly journals Comparative Analysis of Neural Mobilization and Rhythmic Stabilization in Range of Motion and Hip Pain

2020 ◽  
pp. 1-6
Author(s):  
Samyla Maria Araújo Ponte ◽  
Leydnaya Maria Souza ◽  
Bruno Cunha da Costa ◽  
Guilherme Pertinni de Morais Gouveia
Keyword(s):  
Range Of Motion ◽  
External Rotation ◽  
Great Majority ◽  
Hip Pain ◽  
Whole Body ◽  
Active Movement ◽  
The Mean ◽  
Passive Mobilization ◽  
Stabilization Technique ◽  
Hip Flexion

Background: The hip is a structure of the human body in which occurs the junction of bone, articular, muscular and ligament structures. It is in the coxofemoral joint and has the function of supporting the whole-body weight, being one of the main joints responsible for ambulation. Objectives: To analyze the comparison of neural mobilization and rhythmic stabilization techniques in range of motion (ROM) and hip pain. Methods: The sample was composed by 20 patients, with mean age of 54±6 years, were divided into two groups of 10 patients: the patients who received the neural mobilization technique (G1) and the patients who received the rhythmic stabilization technique (G2). Results: The mean age of each group was 56±6 years (G1) and 52±6 years (G2). Among the evaluated, 12 (60%) were female, 14 (70%) were married, predominating the profession of housewife (35%). The great majority of the participants (95%) presented pain to the active movement, mainly to the movements of hip flexion and abduction. Regarding passive mobilization, 70% referred pains, predominating to the movements of hip external rotation and abduction. Conclusion: It was concluded that the neural mobilization and rhythmic stabilization techniques had satisfactory results in relation to ROM and pain in the hip region, but rhythmic stabilization had a greater gain of ROM and decrease of pain.

Mechanisms of acute ankle syndesmosis ligament injuries in professional male rugby union players: a systematic visual video analysis

2020 ◽  
pp. bjsports-2020-102281
Author(s):  
Eamonn Delahunt ◽  
Garreth Farrell ◽  
Andrew Boylan ◽  
Fearghal Kerin ◽  
Peter Tierney ◽  
...  
Keyword(s):  
Video Analysis ◽  
Direct Contact ◽  
External Rotation ◽  
Rugby Union ◽  
Qualitative Description ◽  
Ligament Injuries ◽  
Injured Limb ◽  
Indirect Contact ◽  
Injury Mechanisms ◽  
Hip Flexion

BackgroundThe mechanisms of acute ankle syndesmosis ligament injuries in professional rugby union are not well understood.AimTo describe the mechanisms of acute ankle syndesmosis ligament injuries in male professional rugby union players using systematic visual video analysis.MethodsAll time-loss acute ankle syndesmosis ligament injuries identified via retrospective analysis of the Leinster Rugby injury surveillance database across the 2013/2014 to 2017/2018 seasons were considered as potentially eligible for inclusion. Three Chartered Physiotherapists (analysts) independently assessed all videos with a final consensus meeting convened to describe the injury mechanisms. One of the analysts developed a qualitative description of each injury mechanism.ResultsThirteen acute ankle syndesmosis injuries were included in this study. The most common biomechanical presentation of the injured limb was characterised by hip flexion, knee flexion, knee valgus, ankle dorsiflexion, pronation and external rotation of the foot. Six of the included injuries (46%) were the result of an external load application to the injured limb (ie, direct contact injuries). In the other seven instances (54%), the injury was the result of a collapse of the injured player’s body mass over the injured ankle joint, while tackling or being tackled, without direct contact to the injured limb (ie, indirect contact injuries).ConclusionInjuries incurred while tackling were exclusively the result of suboptimal tackle mechanics. A majority of injuries incurred while being tackled involved a posterior tackle, which often resulted in a posterior collapse of the injured player’s centre of mass over a fixed externally rotated foot.

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