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OBJECTIVE: Evaluate the discriminative and convergent validity of visual scales for the assessment of movement quality in the single-leg squat. METHODS: Searches performed in CINAHL, Cochrane, Embase, PubMed, SPORTDiscus and Web of Science databases. Studies evaluating discriminative and convergent validity of movement quality visual assessments in single-leg squats were included. The COSMIN risk of bias checklist was used to assess the risk of bias, and certainty of evidence was assessed by the GRADE modified version. RESULTS: Ten studies evaluating three different methods of visual assessment of the single-leg squat (Crossley scale; Whatman score and Medial knee displacement) were included. Very low certainty evidence suggests that the Crossley scale had sufficient discriminative validity for patient-centred outcomes. Very low to moderate certainty evidence suggests that the three visual methods of assessment of the single-leg squat had insufficient discriminative validity for surrogate outcomes and groups. None of the three methods had the convergent validity assessed. CONCLUSION: The Crossley scale exhibited sufficient discriminative validity for patient-centred outcomes, although the evidence supporting this conclusion is of very low certainty. Visual scales for the assessment of the single-leg squat movement quality should be used with caution in clinical practice as most methods had insufficient discriminative validity and no reports of convergent validity.
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Pierna , Postura , Humanos , Movimiento , Articulación de la Rodilla , Rodilla , Reproducibilidad de los ResultadosRESUMEN
BACKGROUND: Hip torque ratios are considered a useful measure for patients with hip pain. However, evidence regarding this measure for patients with femoroacetabular impingement syndrome is scarce. The primary aim of this study was to compare hip external-internal rotation and abduction-adduction torque ratios between patients with femoroacetabular impingement syndrome and asymptomatic individuals. The secondary aim was to compare hip torque ratios between the asymptomatic group and femoroacetabular impingement syndrome patients grouped according to the severity of symptoms and functional limitations. METHODS: Hip abduction-adduction and external-internal rotation torque ratios of 134 individuals with femoroacetabular impingement syndrome and 134 asymptomatic matched controls was assessed through isokinetic testing. Severity of symptoms and functional limitations was assessed through the iHOT-33. Mann Whitney U and Kruskall-Wallis tests were used to compare hip torque ratios between asymptomatic individuals and patients with femoroacetabular impingement syndrome and to patients with femoroacetabular impingement syndrome with different severities of symptoms and functional limitations. FINDINGS: No differences were identified in hip abduction-adduction (U = 7659.5, p = 0.192) and external-internal rotation (U = 8787.5, p = 0.764) torque ratios between patients with femoroacetabular impingement syndrome and asymptomatic individuals. Hip abduction-adduction torque ratio was higher (p = 0.0127) in patients with a severe state (median = 1.80, IQR = 0.61) when compared to asymptomatic individuals (median = 1.52, IQR = 0.45) (moderate effect size, r = 0.45). INTERPRETATION: Patients with severe symptoms and functional limitations related to FAI syndrome presented greater hip abduction-adduction torque ratio than asymptomatic individuals, suggesting a decreased adduction torque capacity relative to abduction torque in this subgroup of femoroacetabular impingement.
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Pinzamiento Femoroacetabular , Humanos , Estudios TransversalesRESUMEN
BACKGROUND: The hip abductor muscles control the pelvis in the frontal plane and allow the maintenance of trunk position and dynamic balance during weight-bearing activities. OBJECTIVE: To compare the side-lying and standing positions for hip abductor strength assessment with regards to torque production and myolectric activity. METHOD: Concentric and eccentric hip abductor peak torque and total work, and myoelectric activity of the tensor fascia lata, gluteus medius, and inferior and superior portions of the gluteus maximus muscles were measured during maximal isokinetic tests for hip abductor strength in the side-lying and standing positions. The Wilcoxon test was used to compare variables between the positions. RESULTS: Peak torque values did not differ between side-lying and standing positions for both concentric and eccentric contraction modes (p > .05). During standing position, greater concentric total work was observed (p = .013). This position resulted in a lower activity of the tensor fascia lata muscle (p = .005) compared to side lying position. Myoelectric activity of gluteus medius, and inferior and superior portions of the gluteus maximus was similar between positions (p > .05). CONCLUSION: Both positions presented similar peak torque values and, during the standing position, a greater concentric total work and lesser activation of the tensor fascia lata was observed. Standing position can be used when emphasis on the superior portion of gluteus maximus over the tensor fascia lata is intended.
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Cadera , Posición de Pie , Nalgas , Humanos , Músculo Esquelético/fisiología , MusloRESUMEN
Background The primary aim of this study was to compare knee and hip dynamic muscle strength of individuals with femoroacetabular impingement (FAI) syndrome scheduled for hip arthroscopy with healthy controls. Our secondary aim was to compare hip and knee muscle strength between male and female patients with FAI syndrome. Methods One hundred and thirty-four individuals with femoroacetabular impingement syndrome scheduled for hip arthroscopy and 134 healthy controls matched for sex and age (within 5 years range) underwent an isokinetic assessment of knee extension and flexion and hip abduction, adduction, external rotation and internal rotation dynamic muscle strength. Two MANOVAs were conducted to compare isokinetic peak torque and total work between groups and sexes. Findings Individuals with femoroacetabular impingement syndrome demonstrated lower values of all variables representing knee and hip isokinetic peak torque and total work measures when compared to healthy controls, with differences ranging from 0.09 Nm/kg (95%CI: 0.06-0.12 Nm/kg) to 0.64 Nm/kg (95%CI: 0.49-0.79 Nm/kg). Female participants from both FAI syndrome and control group showed less knee and hip muscle strength compared to male participants. There was no significant interaction between group and sex regarding knee or hip isokinetic peak torque and total work (p > 0.05). Interpretation Individuals with femoroacetabular impingement syndrome scheduled for hip arthroscopy present impairments in knee or hip dynamic muscle strength when compared to controls. Female participants present less knee and hip muscular strength compared to male participants, these between-sex differences are similar for both FAI syndrome and control group participants.
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Pinzamiento Femoroacetabular , Artroscopía , Estudios de Casos y Controles , Femenino , Pinzamiento Femoroacetabular/cirugía , Articulación de la Cadera , Humanos , Masculino , Fuerza Muscular/fisiología , Rango del Movimiento Articular/fisiologíaRESUMEN
BACKGROUND: We assessed the association between: the severity of hip chondral or labral pathology with dynamic hip muscle strength or quality of life in patients with femoroacetabular impingement syndrome scheduled for hip arthroscopy. We also assessed the association between dynamic hip muscle strength with quality of life. METHODS: Eighty-three participants with femoroacetabular impingement syndrome scheduled for hip arthroscopy were included. We measured dynamic hip abduction and adduction muscle strength with an isokinetic dynamometer (Nm/kg), and quality of life with the iHoT-33 questionnaire. The severity of hip chondrolabral pathologies was scored using the modified Beck classification. Linear regression analyses were conducted to assess the association between severity of hip chondral or labral pathology with dynamic hip muscle strength and quality of life. FINDINGS: The regression analyses showed no association between the (i) severity of hip chondral (adjusted r2: 0.14) or labral (adjusted r2: 0.08) pathology and quality of life (P > 0.05), (ii) between the severity of hip chondral or labral pathology and dynamic hip abduction and adduction muscle strength (P > 0.05). Significant correlation was observed for quality of life and hip abduction (adjusted r2:0.29; P < 0.001) or adduction (adjusted r2: 0.32; P < 0.001) muscle strength. INTERPRETATION: The severity of hip chondral or labral pathologies were not associated with quality of life or dynamic hip muscle strength in participants with femoroacetabular impingement syndrome. Greater dynamic hip abduction and adduction muscle strength were associated with better quality of life in participants with femoroacetabular impingement syndrome scheduled for hip arthroscopy.
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Pinzamiento Femoroacetabular , Calidad de Vida , Artroscopía , Estudios Transversales , Pinzamiento Femoroacetabular/cirugía , Articulación de la Cadera/cirugía , Humanos , Fuerza Muscular , Resultado del TratamientoRESUMEN
PURPOSE: Because walking is highly recommended for prevention and treatment of obesity and some of its biomechanical aspects are not clearly understood for overweight people, we compared the absolute and normalized ground reaction forces (GRF), plantar pressures, and temporal parameters of normal-weight and overweight participants during overground walking. METHOD: A force plate and an in-shoe pressure system were used to record GRF, plantar pressures (foot divided in 10 regions), and temporal parameters of 17 overweight adults and 17 gender-matched normal-weight adults while walking. RESULTS: With high effect sizes, the overweight participants showed higher absolute medial-lateral and vertical GRF and pressure peaks in the central rearfoot, lateral midfoot, and lateral and central forefoot. However, analyzing normalized (scaled to body weight) data, the overweight participants showed lower vertical and anterior-posterior GRF and lower pressure peaks in the medial rearfoot and hallux, but the lateral forefoot peaks continued to be greater compared with normal-weight participants. Time of occurrence of medial-lateral GRF and pressure peaks in the midfoot occurred later in overweight individuals. CONCLUSIONS: The overweight participants adapted their gait pattern to minimize the consequences of the higher vertical and propulsive GRF in their musculoskeletal system. However, they were not able to improve their balance as indicated by medial-lateral GRF. The overweight participants showed higher absolute pressure peaks in 4 out of 10 foot regions. Furthermore, the normalized data suggest that the lateral forefoot in overweight adults was loaded more than the proportion of their extra weight, while the hallux and medial rearfoot were seemingly protected.
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Pie/fisiología , Sobrepeso/fisiopatología , Zapatos , Caminata/fisiología , Adaptación Fisiológica , Adulto , Fenómenos Biomecánicos , Índice de Masa Corporal , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Masculino , Presión , Soporte de Peso/fisiologíaRESUMEN
WalkinSense is a new device designed to monitor walking. The aim of this study was to measure the accuracy and repeatability of the gait analysis performed by the WalkinSense system. Descriptions of values recorded by WalkinSense depicting typical gait in adults are also presented. A bench experiment using the Trublu calibration device was conducted to statically test the WalkinSense. Following this, a dynamic test was carried out overlapping the WalkinSense and the Pedar insoles in 40 healthy participants during walking. Pressure peak, pressure peak time, pressure-time integral, and mean pressure at eight-foot regions were calculated. In the bench experiments, the repeatability (i) among the WalkinSense sensors (within), (ii) between two WalkinSense devices, and (iii) between the WalkinSense and the Trublu devices was excellent. In the dynamic tests, the repeatability of the WalkinSense (i) between stances in the same trial (within-trial) and (ii) between trials was also excellent (ICC > 0.90). When the eight-foot regions were analyzed separately, the within-trial and between-trials repeatability was good-to-excellent in 88% (ICC > 0.80) of the data and fair in 11%. In short, the data suggest that the WalkinSense has good-to-excellent levels of accuracy and repeatability for plantar pressure variables.
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Marcha/fisiología , Caminata/fisiología , Adulto , Femenino , Humanos , MasculinoRESUMEN
The current study aimed to compare the shoulder kinematics (3D scapular orientation, scapular angular displacement and scapulohumeral rhythm) of asymptomatic participants under unloaded and loaded conditions during unilateral shoulder elevation in the scapular plane. We used a repeated-measures design with a convenience sample. Eleven male participants with an age range of 21-28 years with no recent history of shoulder injury participated in the study. The participants performed isometric shoulder elevation from a neutral position to approximately 150 degrees of elevation in the scapular plane in intervals of approximately 30 degrees during unloaded and loaded conditions. Shoulder kinematic data were obtained with videogrammetry. During shoulder elevation, the scapula rotated upwardly and externally, and tilted posteriorly. The addition of an external load did not affect 3D scapular orientation, scapular angular displacement, or scapulohumeral rhythm throughout shoulder elevation (P > .05). In clinical practice, clinicians should expect to observe upward and external rotation and posterior tilt of the scapula during their assessments of shoulder elevation. Such behavior was not influenced by an external load normalized to 5% of body weight when performed in an asymptomatic population.
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Elevación , Esfuerzo Físico/fisiología , Rango del Movimiento Articular/fisiología , Escápula/fisiología , Articulación del Hombro/fisiología , Análisis y Desempeño de Tareas , Soporte de Peso/fisiología , Adulto , Humanos , Masculino , RotaciónRESUMEN
Different exercises are prescribed by physiotherapists and despite the popular use of elastic resistance, few studies have investigated the effect of such rehabilitation tools on shoulder resultant net moment (RNM). The aim of the present study was to compare shoulder RNM peak values and the respective angle of occurrence during three shoulder rehabilitation exercises: 1) elevation in the scapular plane; 2) flexion; and 3) abduction when performed in three different load situations: 1) without external load; 2) with dumbbells (DB); and 3) with elastic resistance. Twenty-one healthy subjects participated in the study. Kinematic data were obtained by means of an inverse dynamic model. A two-way ANOVA was used for data analysis (α < 0.05). The highest RNM peak for abductor and external rotator muscles was during shoulder abduction exercise and for flexor muscles was during flexion and elevation in the scapular plane. The DB load condition was associated with highest RNM peak values for all muscle groups. This study presents differences among three exercises and load situations for RNM peak values and angle of occurrence. Furthermore, it also presents theoretical rationale for load progress and selection of exercises for shoulder rehabilitation management. Clinicians should consider it, when prescribing strengthening exercises for shoulder rehabilitation.