1
|
Bourgeault-Gagnon Y, Lin D, Salmon LJ, Gooden BR, Lyons MC, Martina K, Tai JY, O'Sullivan MD. Gluteal Tendinopathy Is Associated With Lower Patient-Reported Outcome Measures in Total Hip Arthroplasty With a Posterior Approach: A Prospective Cohort Study of 1,538 Patients. J Arthroplasty 2024; 39:1796-1803. [PMID: 38331357 DOI: 10.1016/j.arth.2024.01.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Gluteal tendinopathy (GT) is found in 20 to 25% of patients undergoing total hip arthroplasty (THA). Despite this, there is a scarcity of literature assessing the association between GT and THA outcomes. The aim of this study was to evaluate whether intraoperative diagnosis of GT negatively affected postoperative outcomes. METHODS Consecutive patients undergoing primary THA for osteoarthritis via a posterior approach over 5 years were recruited in a prospective study. Gluteal tendinopathy was assessed and graded at the time of surgery, but not repaired. A total of 1,538 (93%) completed the patient-reported outcome measures (PROMs) at 1 year after surgery and were included in the analysis. The PROMs included the Oxford Hip Score (OHS), Hip Disability and Osteoarthritis Outcome Score Joint Replacement (HOOS JR), and EuroQol 5-Dimension, and were collected preoperatively and one year after THA. RESULTS The gluteal tendons were graded as 4 distinct grades: normal (n = 1,023, 66%), tendinopathy but no tear (n = 337, 22%), partial thickness tear (n = 131, 9%), and full thickness tear (n = 47, 3%). The occurrence of GT was associated with age, body mass index, and sex. There was no significant difference in baseline OHS or HOOS JR scores according to GT grade. As GT grade increased, lower median 1-year OHS (P = .001) and HOOS JR (P = .016) were observed. This association was confirmed by linear regression analysis with 1-year OHS (B = 0.5, 95% CI = -0.9 to -0.1, P = .011) when controlled for age and sex. CONCLUSIONS Gluteal tendinopathy was commonly observed and was associated with inferior 1-year PROMs in patients undergoing THA via posterior approach. Increasing degree of tendinopathy was a negative prognostic factor for outcomes and patient satisfaction. LEVEL OF EVIDENCE Level 2 (High quality prospective cohort study).
Collapse
Affiliation(s)
- Yoan Bourgeault-Gagnon
- North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, New South Wales, Australia
| | - David Lin
- North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, New South Wales, Australia
| | - Lucy J Salmon
- North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, New South Wales, Australia; University of Notre Dame, Medical School, Sydney, New South Wales, Australia
| | - Benjamin R Gooden
- North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, New South Wales, Australia
| | - Matthew C Lyons
- North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, New South Wales, Australia
| | - Ka Martina
- Department of Orthopaedics, Mater Hospital, Wollstonecraft, New South Wales, Australia
| | - Jeffrey Y Tai
- University of New South Wales, School of Clinical Medicine, UNSW Sydney, Sydney, Australia
| | - Michael D O'Sullivan
- North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, New South Wales, Australia
| |
Collapse
|
2
|
Almousa S, Vicenzino B, Mellor R, Grimaldi A, Bennett K, Doyle F, McCarthy GM, McDonough SM, Ryan JM, Lynch K, Sorensen J, French HP. An EDucation and eXercise intervention for gluteal tendinopathy in an Irish setting: a protocol for a feasibility randomised clinical trial (LEAP-Ireland RCT). HRB Open Res 2024; 6:76. [PMID: 39045032 PMCID: PMC11263908 DOI: 10.12688/hrbopenres.13796.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2024] [Indexed: 07/25/2024] Open
Abstract
Background Gluteal tendinopathy (GT) is a degenerative tendon condition characterised by pain over the greater trochanter of the hip. A randomised controlled trial (RCT) in Australia found that 14 sessions of EDucation on load management plus eXercise (EDX) delivered over 8 weeks resulted in greater improvements in global rating of change and pain outcomes at 8 and 52 weeks, compared with corticosteroid injection or 'wait and see'. Typically, 5-6 physiotherapy sessions are provided in public and private physiotherapy settings in Ireland, therefore, the aim of this study is to examine the feasibility of conducting a future definitive RCT to investigate effectiveness of 6 sessions of the EDX programme compared to usual care. Methods We will randomly allocate 64 participants with GT to physiotherapist-administered EDX or usual care. The EDX intervention (EDX-Ireland) will be delivered in 6 sessions over 8 weeks.To determine feasibility of an RCT, we will assess recruitment and retention and outcome measure completion. The health status outcomes to be assessed at baseline, 8 weeks and 3 months include: Global Rating of Change, pain severity, the Victorian Institute of Sport Assessment-Gluteal Questionnaire (VISA-G), the Patient-Specific Functional Scale, the Pain Catastrophizing Scale, Patient Health Questionnaire (PHQ), Pain Self-Efficacy Questionnaire, the EQ-5D-5L, the Central Sensitisation Inventory and hip abductor muscle strength. We will explore acceptability of the EDX-Ireland intervention from the perspective of patients and treatment providers, and the perspective of referrers to the trial. A Study Within A Trial will be also applied to compare recording of exercise adherence using app-based technology to paper diaries. Discussion There is a need to establish effective treatments for GT that potentially can be implemented into existing health systems. The findings of this feasibility trial will inform development of a future definitive RCT. Registration The trial is registered prospectively on ClinicalTrials.gov ( NCT05516563, 27/10/2022).
Collapse
Affiliation(s)
- Sania Almousa
- School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Rebecca Mellor
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Alison Grimaldi
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Kathleen Bennett
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Frank Doyle
- Department of Health Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Geraldine M. McCarthy
- Department of Rheumatology, Mater Misericordiae University Hospital, Dublin, Ireland
| | | | - Jennifer M. Ryan
- School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Jan Sorensen
- Health Outcomes Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Helen P. French
- School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland
| |
Collapse
|
3
|
Mediators and Moderators of Education Plus Exercise on Perceived Improvement in Individuals With Gluteal Tendinopathy: An Exploratory Analysis of a 3-Arm Randomized Trial. J Orthop Sports Phys Ther 2022; 52:826-836. [PMID: 36306175 DOI: 10.2519/jospt.2022.11261] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE: To investigate mediators and moderators of effects of an education-plus-exercise program compared to corticosteroid injections or wait and see on perceived improvement in individuals with gluteal tendinopathy. METHODS: Exploratory analysis from a clinical trial (n = 204) comparing education plus exercise, corticosteroid injection, and wait and see on global rating of change at 52 weeks. Potential mediators measured at baseline and 8 weeks were hip active abduction range, abductor muscle torque, pain self-efficacy, pain constancy, and patient-specific function. Potential moderators at baseline were Victorian Institute of Sport Assessment for gluteal tendinopathy, menopausal status, symptom duration, magnetic resonance imaging-determined tendon pathology, and pain catastrophizing. RESULTS: There is evidence from mediation analysis that the beneficial effect of education plus exercise on global rating of change relative to corticosteroid injection or wait and see may be due to changes in patient-specific function (indirect effect relative risk; 95% CI: 1.14 [1.05-1.29], 1.29 [1.12-1.58], respectively), pain constancy (1.12 [1.03-1.27], 1.2 [1.08-1.41]), and pain self-efficacy (1.1 [1.02-1.25], 1.18 [1.04-1.44])-not active hip movement/muscle torque. Moderation analysis did not support our included patient characteristics. CONCLUSION: Education plus exercise is likely to improve global rating of change for persons with gluteal tendinopathy relative to corticosteroid injection and wait and see through improvements in patient-specific function, pain self-efficacy, and reduced pain constancy. We found no evidence of differences in the effect of education plus exercise in patient subgroups based on disability, menopausal status, symptom duration, tendon pathology, or pain catastrophizing. J Orthop Sports Phys Ther 2022;52(12):826-836. Epub: 17 October 2022. doi:10.2519/jospt.2022.11261.
Collapse
|
4
|
Siebers HL, Eschweiler J, Michalik R, Migliorini F, Tingart M, Betsch M. Biomechanical compensation mechanisms during stair climbing - The effect of leg length inequalities. Gait Posture 2022; 91:290-296. [PMID: 34798420 DOI: 10.1016/j.gaitpost.2021.10.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 09/01/2021] [Accepted: 10/12/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Stair climbing is a complex and demanding daily activity with increased physical loads. Therefore, analyzing stair climbing abilities is a frequently used diagnostic tool. Leg length inequalities (LLIs) are a common condition in the population, with individual consequences like lower back pain, scoliosis, and osteoarthritis. Despite its high prevalence, the necessary treatment, for mild LLIs, is still controversial. Previously, the focus was to analyze the effects of LLIs during static standing and walking. To create a holistic view on the dynamic effects of LLIs, and since climbing stairs produces a similar biomechanical imbalance as LLIs, the compensation mechanics during stair climbing are of special interest. RESEARCH QUESTION What are the biomechanical compensation mechanisms of (simulated) LLIs during ascending and descending stairs? METHODS Thirty-five healthy participants were measured with the inertial measurement system MyoMotion during stair climbing with simulated LLIs of 0-3 cm. The maximum estimated lower limb joint angles of the long and short leg were analyzed with statistically repeated measurement models. RESULTS The long leg showed significantly increased hip and knee flexion, while the short leg showed decreased hip and knee flexion, decreased dorsiflexion, and significantly increased plantarflexion. Different mechanisms were found in the case of 1 cm LLI when compared to greater LLIs. In the former, increased hip and knee flexion in the short leg accompanied by increased dorsiflexion in the long leg was observed. In the latter, the dorsiflexion of the long leg was reduced. SIGNIFICANCE Except for the reduced dorsiflexion of the long leg (LLI >1 cm), during stair climbing compared compensation mechanisms as during walking were presented, with the long leg functionally shortened and the short leg lengthened. Although the feet were already on different levels, during stair climbing with the step-over-step technique, significant compensation mechanisms were found as a consequence of LLIs.
Collapse
Affiliation(s)
- Hannah Lena Siebers
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany.
| | - Jörg Eschweiler
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Roman Michalik
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Filippo Migliorini
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Markus Tingart
- Department of Orthopaedic Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Marcel Betsch
- Department of Orthopaedics and Trauma Surgery, University Medical Center Mannheim of the University Heidelberg, Mannheim, Germany
| |
Collapse
|
5
|
Kanwar KD, Cannon J, Nichols DL, Salem GJ, Mann MD. Injury risk-factor differences between two golf swing styles: a biomechanical analysis of the lumbar spine, hip and knee. Sports Biomech 2021:1-22. [PMID: 34280079 DOI: 10.1080/14763141.2021.1945672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 06/14/2021] [Indexed: 10/20/2022]
Abstract
The golf swing has been associated with mechanical injury risk factors at many joints. One swing, the Minimalist Golf Swing, was hypothesised to reduce lumbar spine, lead hip, and lead knee ranges of motion and peak net joint moments, while affecting swing performance, compared to golfers' existing swings. Existing and MGS swings of 15 golfers with handicaps ranging from +2 to -20 were compared. During MGS downswing, golfers had 18.3% less lumbar spine transverse plane ROM, 40.7 and 41.8% less lead hip sagittal and frontal plane ROM, and 39.2% less lead knee sagittal plane ROM. MGS reduced lead hip extensor, abductor, and internal rotator moments by 17.8, 19.7 and 43%, while lead knee extensor, abductor, adductor and external rotator moments were reduced by 24.1, 26.6, 37 and 68.8% respectively. With MGS, club approach was 2° shallower, path 4° more in-to-out and speed 2 m/s slower. MGS reduced certain joint ROM and moments that are linked to injury risk factors, while influencing club impact factors with varying effect. Most golf injuries are from overuse, so reduced loads per cycle with MGS may extend the healthy life of joints, and permit golfers to play injury-free for more years.
Collapse
Affiliation(s)
- Kiran D Kanwar
- Department of Kinesiology, Texas Woman's University, Denton, TX, USA
- Golf Department, Stanton University, Garden Grove, CA, USA
| | - Jordan Cannon
- Musculoskeletal Biomechanics Research Laboratory, Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - David L Nichols
- Department of Kinesiology, Texas Woman's University, Denton, TX, USA
| | - George J Salem
- Musculoskeletal Biomechanics Research Laboratory, Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - Mark D Mann
- Department of Kinesiology, Texas Woman's University, Denton, TX, USA
| |
Collapse
|
6
|
Moore D, Semciw AI, Wisbey-Roth T, Pizzari T. Adding hip rotation to therapeutic exercises can enhance gluteus medius and gluteus minimus segmental activity levels – An electromyography study. Phys Ther Sport 2020; 43:157-165. [DOI: 10.1016/j.ptsp.2020.02.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 01/12/2023]
|
7
|
Plinsinga ML, Ross MH, Coombes BK, Vicenzino B. Physical findings differ between individuals with greater trochanteric pain syndrome and healthy controls: A systematic review with meta-analysis. Musculoskelet Sci Pract 2019; 43:83-90. [PMID: 31369906 DOI: 10.1016/j.msksp.2019.07.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 06/13/2019] [Accepted: 07/24/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Understanding of the biopsychosocial characteristics of greater trochanteric pain syndrome (GTPS), a prevalent lower limb tendinopathy, is currently lacking. OBJECTIVES To quantify differences in participant characteristics between individuals with GTPS and healthy control participants. DESIGN Systematic review of original studies with meta-analyses where appropriate. METHODS A comprehensive electronic search was undertaken in Pubmed, EMBASE, Web of Science and CINAHL for terms referring to GTPS. Studies that provided comparison of individuals with clinically characterized GTPS with healthy controls were included. Study quality was rated with the Joanna Briggs Institute Critical Appraisal Checklist for Cross Sectional Studies. Standardized mean differences were calculated and supported by narrative synthesis or meta-analyses where appropriate. Certainty of evidence was assessed based on the GRADE guidelines. RESULTS The search revealed 2798 studies, of which 13 studies from five research groups were included. There were 229 participants with at least three months duration of GTPS and 193 control participants. Individuals with GTPS displayed larger greater trochanteric width, greater body mass index, lower hip abductor muscle strength, higher hip abductor muscle activity, altered single leg loading and gait parameters including shorter step length and velocity. No studies investigating psychological features or sensory perception were identified. Quality of life was investigated in a single study. CONCLUSIONS Compared to healthy controls, participants with GTPS are more overweight, have poorer hip abductor muscle function and altered gait parameters. Overall quality of evidence across studies was very low based on GRADE guidelines.
Collapse
Affiliation(s)
- Melanie Louise Plinsinga
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Megan Heather Ross
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Brooke Kaye Coombes
- School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia.
| |
Collapse
|
8
|
French HP, Woodley SJ, Fearon A, O'Connor L, Grimaldi A. Physiotherapy management of greater trochanteric pain syndrome (GTPS): an international survey of current physiotherapy practice. Physiotherapy 2019; 109:111-120. [PMID: 31493863 DOI: 10.1016/j.physio.2019.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study aimed to establish and compare current physiotherapy management of GTPS in Australia, New Zealand (NZ) and Ireland. DESIGN Cross-sectional observational survey of physiotherapists. METHODS An online survey was distributed to registered musculoskeletal physiotherapists in Australia, NZ and Ireland. Ordinal and nominal data were analysed using frequency counts or mean ranks; median and interquartile ranges were calculated for numerical data. Inter-country comparisons were made using Chi-squared analyses for nominal/ordinal data and Kruskal-Wallis tests for numerical data. Statistical significance was set at P<0.05. RESULTS/FINDINGS Valid responses were received from 361 physiotherapists, 61% were female and 80% worked in private practice. Overall, consistency in treatment of GTPS was observed across the three countries. All physiotherapists used education and exercise (most commonly strengthening and neuromuscular control) primarily targeting the gluteal muscles. Other interventions included massage (90%), stretching (53%), range of motion (40%), thermal modalities (50%), taping (38%) and electrotherapy (25%), whilst 40% commonly recommended up to 2 to 3 corticosteroid injections per patient/per annum. Physiotherapists used pain severity scales as their primary outcome measure (79%). Single leg stance was the most common physical measure used (68%), and global rating scores or standardised physical measures were less commonly used. CONCLUSION This international survey established the physiotherapy management of GTPS. Education used in conjunction with exercise is in line with current evidence, but a proportion of clinicians use adjunct treatments without clear rationale or supporting evidence. Results indicate the need to further define optimal management of GTPS using robust methodologies such as randomised controlled trials.
Collapse
Affiliation(s)
| | - S J Woodley
- Department of Anatomy, School of Biomedical Sciences, University of Otago, New Zealand.
| | - A Fearon
- UCRISE, Faculty of Health, University of Canberra, Australia.
| | | | - A Grimaldi
- Physiotec Physiotherapy, Brisbane, Australia; School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.
| |
Collapse
|
9
|
Chang WJ, O'Connell NE, Beckenkamp PR, Alhassani G, Liston MB, Schabrun SM. Altered Primary Motor Cortex Structure, Organization, and Function in Chronic Pain: A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2018; 19:341-359. [DOI: 10.1016/j.jpain.2017.10.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 10/15/2017] [Accepted: 10/19/2017] [Indexed: 01/14/2023]
|
10
|
Plinsinga M, Coombes B, Mellor R, Nicolson P, Grimaldi A, Hodges P, Bennell K, Vicenzino B. Psychological factors not strength deficits are associated with severity of gluteal tendinopathy: A cross-sectional study. Eur J Pain 2018; 22:1124-1133. [DOI: 10.1002/ejp.1199] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2018] [Indexed: 01/12/2023]
Affiliation(s)
- M.L. Plinsinga
- School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Qld Australia
| | - B.K. Coombes
- School of Biomedical Sciences; The University of Queensland; Brisbane Qld Australia
| | - R. Mellor
- School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Qld Australia
| | - P. Nicolson
- Centre for Health, Exercise and Sports Medicine; Department of Physiotherapy; University of Melbourne; Carlton Vic. Australia
| | - A. Grimaldi
- School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Qld Australia
- Physiotec; Tarragindi Qld Australia
| | - P. Hodges
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health; School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Qld Australia
| | - K. Bennell
- Centre for Health, Exercise and Sports Medicine; Department of Physiotherapy; University of Melbourne; Carlton Vic. Australia
| | - B. Vicenzino
- School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Qld Australia
| |
Collapse
|
11
|
Matheve T, De Baets L, Rast F, Bauer C, Timmermans A. Within/between-session reliability and agreement of lumbopelvic kinematics in the sagittal plane during functional movement control tasks in healthy persons. Musculoskelet Sci Pract 2018; 33:90-98. [PMID: 28844565 DOI: 10.1016/j.msksp.2017.08.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 08/18/2017] [Accepted: 08/20/2017] [Indexed: 01/14/2023]
Abstract
A lack of adequate lumbopelvic movement control has been suggested as an underlying mechanism contributing to the development and persistence of low back pain and lower limb pathologies. The purpose of this study was to assess the within and between session reliability (i.e. the ability to discriminate between subjects), and the agreement (i.e. whether scores are identical on repeated measures) of lumbopelvic kinematics in the sagittal plane during functional movement control tasks. Kinematics were measured with a portable inertial measurement unit system. Twenty healthy subjects (mean age = 22 (±3.6) years, 15 females) performed four tasks on two occasions, five to seven days apart: standing bow (SB), lifting a box from the floor (LIFT), stance-to-sit-to-stance (SIT) and placing a box on an overhead shelf (OVERH). Participants were asked to keep the lumbar spine in a neutral lordosis during the tasks. The maximal deviations from the neutral starting position for the lumbar spine and hip were calculated. Intraclass correlations (ICCs), standard errors of measurement (SEM), minimal detectable changes and 95% limits of agreement were used to assess reliability and agreement. SB and LIFT were substantially reliable (ICC = 0.89-0.96), SIT was moderately to substantially reliable (ICC = 0.69-0.92) and OVERH was fairly to moderately reliable (ICC = 0.40-0.67). SEMs ranged between 1.1° and 3.1° for the lumbar spine and between 0.7° and 4.8° for the hip. Based on the substantial reliability and acceptable agreement, SB and LIFT are most appropriate to quantify lumbopelvic movement control during functional tasks.
Collapse
Affiliation(s)
- Thomas Matheve
- Hasselt University, Faculty of Medicine and Life Sciences, Agoralaan, building A, 3590 Diepenbeek, Belgium.
| | - Liesbet De Baets
- Hasselt University, Faculty of Medicine and Life Sciences, Agoralaan, building A, 3590 Diepenbeek, Belgium.
| | - Fabian Rast
- Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Technikumstrasse 71, 8400 Winterthur, Switzerland.
| | - Christoph Bauer
- Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Technikumstrasse 71, 8400 Winterthur, Switzerland.
| | - Annick Timmermans
- Hasselt University, Faculty of Medicine and Life Sciences, Agoralaan, building A, 3590 Diepenbeek, Belgium.
| |
Collapse
|