Association between trunk muscles characteristics with lower limb injuries: A systematic review

Trunk muscle endurance in individuals with and without patellofemoral pain: Sex differences and correlations with performance tests

OBJECTIVES

To compare trunk muscle endurance among females and males with and without patellofemoral pain (PFP), and to investigate the correlations between trunk muscle endurance and performance of the single leg hop test (SLHT) and forward step-down test (FSDT).

DESIGN

Cross-sectional.

SETTING

Laboratory-based study.

PARTICIPANTS

110 females and 38 males with PFP, 61 females and 31males without PFP.

MAIN OUTCOME MEASURES

Anterior and lateral trunk muscle endurance were assessed with the prone and bilateral side-bridge tests, respectively. Performance during the SLHT and FSDT was also assessed.

RESULTS

Lower anterior and lateral trunk muscle endurance were identified in females (p < .001; d = -0.74 to -0.86), but not in males (p ≥ .806; d = -0.04 to 0.05) with PFP as compared to sex-matched controls. Moderate to large, positive correlations between anterior and lateral trunk muscle endurance with performance in the SLHT and FSDT were identified in females (r = .27 to .50; p < .004) and males (r = 0.27 to 0.59; p < .031) with PFP and females without PFP (r = 0.26 to 0.40; p < .044).

CONCLUSION

Our findings highlight that assessing trunk muscle endurance is advised in females with PFP. Trunk muscle endurance of individuals with PFP may have a role in the performance of hopping and stepping down tasks.

A self-oblique exercise that activates the coordinated activity of abdominal and hip muscles-A pilot study

The importance of an interaction between trunk stability muscles and hip muscle function has been suggested. However, reported exercises rarely act on the trunk and hip muscles simultaneously. Here, we devised an abdominal oblique and hip muscle exercise, the Self-oblique exercise (SOE). We examined whether SOE activated abdominal and hip muscles in the supine and half-kneeling positions, compared with abdominal crunch (AC) and plank exercises; and whether participants could modulate the exercise load. Participants were 20 healthy males with some sports experience such as football and baseball on average 10.5 ± 4.0 years. Participants applied self-pressure to their right thighs using the contralateral upper limb with 40% or 70% of the maximum force in Supine SOE and Half- kneeling SOE. The following abdominal and hip muscles were measured using surface electromyography: bilateral external obliques (EO), bilateral internal obliques (IO), right rectus abdominis, right gluteus medius (GMed), and right adductor longus (ADD). All evaluated muscle groups showed significant differences between exercises (p < 0.001). Supine SOE-70% showed 80.4% maximal voluntary contraction (MVC) for left EO (p < 0.017), 61.4% MVC for right IO (p < 0.027), 24.3% MVC for GMed (p < 0.002), and 42.4% MVC for ADD (p < 0.004); these were significantly greatest among all exercises. Muscle activity during Supine SOE-70% was greater than that during Supine SOE-40%. Similarly, Half-kneeling SOE-40% promoted abdominal and hip muscle exertion, and showed more significant activity in GMed (p < 0.006) and ADD (p < 0.001) than AC and plank. SOE could activate abdominal and hip muscles depends on the pressure applied by upper limb. Also, SOE allows participants to modulate the exercise load in a self-controlled step by step manner. Modulation of the exercise load is difficult in AC or plank compared to SOE, and AC or plank cannot obtain simultaneous oblique and hip muscle activity. SOE could be practiced anywhere, in various positions, without any tools.

Clinical utility of measuring the size of the lumbar multifidus and quadratus lumborum muscles in the Australian football league setting: A prospective cohort study

OBJECTIVES

Test the odds of factors previously associated with lower limb injury (decreased size of the multifidus (MF) and increased size of the quadratus lumborum (QL) muscle) in an independent sample of Australian Rules Football (ARF) players.

DESIGN

Prospective cohort study.

SETTING

Professional ARF.

PARTICIPANTS

Forty-three male ARF players.

MAIN OUTCOME MEASURES

Cross-sectional areas (CSAs) of MF and QL muscles measured from pre-season ultrasound images. Playing season injuries were recorded by club personnel. A multivariable logistic regression model was used to evaluate the usefulness of MF and QL muscle size for predicting playing season lower limb injuries.

RESULTS

Fifteen players (35%) sustained a playing season lower limb injury. The multivariable model indicated that the odds of sustaining a lower limb injury during the season was 2.38 (95% CI: 1.18, 5.00; P = 0.017) times less likely for a one cm² increase from the mean value in MF muscle CSA at the L5 vertebral level after adjusting for CSA of the QL, age and BMI. The main effect and interaction models positively predicted 75% of players that sustained a lower limb injury during the season (sensitivity 80%, specificity 85%).

CONCLUSION

Future studies could examine the efficacy, feasibility and adherence of 'at risk' players to a pre-season training program aimed at increasing MF muscle size and monitor playing season injuries.

Lower Trunk Muscle Thickness Is Associated With Pain in Women With Patellofemoral Pain

OBJECTIVES

To compare trunk muscle thickness of women with and without patellofemoral pain (PFP) and to assess the association of trunk muscle thickness with self-reported pain of women with PFP.

METHODS

Forty-four women were recruited and divided into 2 groups: a PFP group (n = 22) and a pain-free group (n = 22). The thickness of the following trunk muscles was obtained by B-mode ultrasound imaging: transversus abdominis, obliquus internus (OI), obliquus externus (OE), rectus abdominis, and multifidus. Self-reported pain was measured on a visual analog scale.

RESULTS

The 44 participants were 18 to 35 years old. Women with PFP had lower thickness of the OI and OE than pain-free women, with moderate or large effect sizes ranging from -0.78 to -0.98, which was negatively related to self-reported pain correlations (r = -0.53 to -0.40). The contraction ratios of the OI and OE were also lower in women with PFP than in pain-free women (P < .05). No differences between groups were found for the transversus abdominis, multifidus, and rectus abdominis, with also no correlation with self-reported pain.

CONCLUSIONS

Lower thickness of the OI and OE is present in women with PFP, which is related to self-reported pain. These findings might help in understanding the alterations in trunk biomechanics of individuals with PFP and the mechanisms by which interventions targeting trunk muscle strength are beneficial to individuals with PFP.