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Waiteman MC, Garcia MC, Briani RV, Norte G, Glaviano NR, De Azevedo FM, Bazett-Jones DM. Can Clinicians Trust Objective Measures of Hip Muscle Strength From Portable Dynamometers? A Systematic Review With Meta-analysis and Evidence Gap Map of 107 Studies of Reliability and Criterion Validity Using the COSMIN Methodology. J Orthop Sports Phys Ther 2023; 53:655-672. [PMID: 37787581 DOI: 10.2519/jospt.2023.12045] [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] [Indexed: 10/04/2023]
Abstract
OBJECTIVE: To summarize the evidence on reliability and criterion validity of hip muscle strength testing using portable dynamometers. DESIGN: Systematic review with meta-analysis. LITERATURE SEARCH: Five databases were searched from inception to March 2023. STUDY SELECTION CRITERIA: We included studies investigating reliability or criterion validity of hip flexor, extensor, abductor, adductor, or internal/external rotator strength testing with portable dynamometers in injury-free individuals or those with pelvic/lower limb musculoskeletal disorders. DATA SYNTHESIS: We performed meta-analyses for each muscle group, position, and method of fixation. We rated pooled results as sufficient (>75% of studies with correlations ≥0.70), insufficient (>75% of studies with correlations <0.70), or inconsistent (sufficient/insufficient results). We assessed the quality of evidence, created evidence gap maps, and made clinical recommendations. RESULTS: We included a total of 107 studies (reliability 103, validity 14). The intrarater and interrater reliability for hip muscle strength testing across different positions and methods of fixation was sufficient (intraclass correlation coefficient = 0.78-0.96) with low- to high-quality evidence. Criterion validity was less investigated and mostly inconsistent (very low-to moderate-quality evidence) with a wide range of correlations (r = 0.40-0.93). CONCLUSION: Hip muscle strength testing using portable dynamometers is reliable. The use of portable dynamometers as clinical surrogates for measuring strength using an isokinetic dynamometer requires further investigation. Clinicians testing hip muscle strength with portable dynamometers should use external fixation seated for hip flexors, prone or supine for hip extensors, side-lying or supine for abductors and adductors, and prone and seated for internal and external rotators. J Orthop Sports Phys Ther 2023;53(11):655-672. Epub 3 October 2023. doi:10.2519/jospt.2023.12045.
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Ishøi L, Thorborg K, Krohn L, Louis Andersen L, Møller Nielsen A, Bek Clausen MI. Maximal and Explosive Muscle Strength During Hip Adduction Squeeze and Hip Abduction Press Test Using A Handheld Dynamometer: An Intra- and Inter-tester Reliability Study. Int J Sports Phys Ther 2023; 18:905-916. [PMID: 37547845 PMCID: PMC10399103 DOI: 10.26603/001c.83259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 05/16/2023] [Indexed: 08/08/2023] Open
Abstract
Background Hip adduction and abduction muscle function plays an important role for risk of groin pain in athletes. Maximal isometric strength can be obtained clinically using a handheld dynamometer. However, in very strong athletes this is challenging, as external fixation of the dynamometer is needed for reliable measures. An alternative to unilateral testing, is the long-lever hip adduction squeeze test and a novel bilateral hip abduction press test. While promising intra-tester reliability has been found for maximal strength during the long-lever hip adduction squeeze test, inter-tester reliability may be more challenging during both maximal and explosive strength measurements. Hypothesis/purpose The aim of the present study was to assess intra- and inter-tester reliability of maximal, and explosive strength during the long lever hip adduction squeeze test and the long lever hip abduction press test in healthy adults using a hand-held dynamometer. Study design Intra- and interrater reliability study. Methods Forty-nine healthy subjects were included for intra- (n=20) and inter-tester reliability (n=29). Subjects performed the hip adduction long lever squeeze test and the bilateral hip abduction press test in a randomized order. Maximal isometric strength and early (0-100 ms) and late (0-200 ms) phase rate of force development (explosive muscle strength) was obtained using a hand-held dynamometer. Relative reliability for all tests was assessed using ICC2,1 two-way mixed model with absolute agreement, thereby taking bias between testers into account. Results Maximal isometric strength showed good intra- and inter-tester reliability for adduction (ICC: 0.93-0.97) and abduction (ICC: 0.88-0.92). For 0-200 ms rate of force development, both the squeeze and press test showed good intra-tester reliability (ICC: 0.85-0.87), whereas inter-tester reliability was good for hip adduction squeeze (ICC: 0.75) and moderate for hip abduction press (ICC: 0.71). For 0-100 ms rate of force development, the hip abduction press test showed good intra-tester reliability (ICC: 0.78). Remaining tests for intra- and inter-tester reliability showed moderate reliability (ICC: 0.50-0.71). Conclusion Assessment of maximal isometric strength in hip adduction squeeze and abduction press test showed good intra- and inter-tester reliability, whereas only 0-200 ms rate of force development demonstrated good intra-tester reliability of both tests. Therefore, rate of force development should preferably be conducted by the same tester, while the long lever squeeze and press test can reliably be used within- and between testers to measure maximal isometric strength. Level of Evidence 3©The Author(s).
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Affiliation(s)
- Lasse Ishøi
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery Copenhagen University Hospital
| | - Kristian Thorborg
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery Copenhagen University Hospital
| | - Laura Krohn
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery Copenhagen University Hospital
| | | | - Asger Møller Nielsen
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery Copenhagen University Hospital
| | - MIkkel Bek Clausen
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery Copenhagen University Hospital
- University College Copenhagen
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Beynnon BD, Tourville TW, Hollenbach HC, Shultz S, Vacek P. Intrinsic Risk Factors for First-Time Noncontact ACL Injury: A Prospective Study of College and High School Athletes. Sports Health 2023; 15:433-442. [PMID: 36154754 PMCID: PMC10170220 DOI: 10.1177/19417381221121136] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND A comprehensive understanding of the intrinsic risk factors for anterior cruciate ligament (ACL) disruption is important for identifying individuals at increased risk for suffering this trauma and developing interventions to mitigate risk. HYPOTHESIS A variety of risk factors predispose athletes to first-time, noncontact ACL injury and some of these differ between male and female athletes. STUDY DESIGN Prospective cohort study with nested case-control sampling. LEVEL OF EVIDENCE Level 2. METHODS Sport teams at 28 high schools and 8 colleges were monitored prospectively over 4 years, and 109 of 130 athletes who suffered their first noncontact ACL injury participated in the study. At the time of injury, matched control subjects were randomly selected from among the case's teammates and a total of 227 athletes participated. Demographic characteristics, joint laxity, lower extremity alignment, strength, and personality characteristics were measured. The association of each risk factor with injury risk was assessed by conditional logistic regression. RESULTS The risk factors that were associated with ACL injury in both male and female athletes included having a parent with prior ACL injury and increases of the following variables: body weight, anterior displacement of the tibia relative to the femur, genu recurvatum, and generalized joint laxity. Risk factors that are unique to female athletes included increased body mass index, increased trunk flexion strength, and prior non-ACL knee injury. The risk factors specific to male athletes were decreased standing quadriceps angle, decreased hip adduction strength, and chronic disease. CONCLUSION A diverse set of risk factors predispose both male and female athletes to ACL injury, whereas others appear to be sex-specific. CLINICAL RELEVANCE Different approaches for assessing risk and preventing ACL injury are needed for male and female athletes. In addition, personalized prevention strategies may be needed to target the specific characteristics that place an individual at increased risk of suffering this trauma.
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Affiliation(s)
- Bruce D. Beynnon
- Department of Orthopedics and
Rehabilitation, Robert Larner College of Medicine, University of Vermont,
Burlington, Vermont
- Department of Electrical and Biomedical
Engineering, University of Vermont, Burlington, Vermont
| | - Timothy W. Tourville
- Department of Orthopedics and
Rehabilitation, Robert Larner College of Medicine, University of Vermont,
Burlington, Vermont
- Department of Rehabilitation and
Movement Science, College of Nursing and Health Sciences, University of Vermont,
Burlington, Vermont
| | - Helen C. Hollenbach
- Department of Orthopedics and
Rehabilitation, Robert Larner College of Medicine, University of Vermont,
Burlington, Vermont
| | - Sandy Shultz
- Department of Kinesiology, School of
Health and Human Sciences, University of North Carolina at Greensboro, Greensboro,
North Carolina
| | - Pamela Vacek
- Department of Medical Biostatistics,
Robert Larner College of Medicine, University of Vermont, Burlington, Vermont
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Gonçalves BAM, Mesquita RNO, Tavares F, Brito J, Correia P, Santos P, Mil-Homens P. A New Portable Device to Reliably Measure Maximal Strength and Rate of Force Development of Hip Adduction and Abduction. J Strength Cond Res 2022; 36:2465-2471. [PMID: 35696597 DOI: 10.1519/jsc.0000000000003872] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
ABSTRACT Gonçalves, BM, Mesquita, RNO, Tavares, F, Brito, J, Correia, P, Santos, P, and Mil-Homens, P. A new portable device to reliably measure maximal strength and rate of force development of hip adduction and abduction. J Strength Cond Res 36(9): 2465-2471, 2022-Groin injuries are a major issue in sports involving kicking or quick changes of direction. Decreased hip adduction and abduction strength have been indicated as one of the main risk factors for groin injury. The methods currently available to measure hip adduction and abduction strength are reliable but highly dependent on the evaluator skills. Furthermore, several studies have reported the reliability of maximal strength (MVIC), but very few studies investigated the reliability of explosive strength (RFD), a parameter that has been previously shown to have a higher functional value. The aim of the current investigation was to assess the reliability of a user-independent portable dynamometer that concurrently measures MVIC and RFD. Twenty-five healthy young subjects performed maximal isometric hip adduction and abduction in both sitting and supine positions. Measurements occurred in 2 different days separated by 48-72 hours. Test-retest reliability was calculated for both MVIC and RFD. Both MVIC and RFD showed good relative reliability (intraclass correlation coefficient = 0.77-0.98) with no differences between positions or muscle actions. Measurement error was similar between positions for MVIC in both hip adduction and abduction. Measurements of RFD showed higher reliability using a time window of at least 0-100 milliseconds, and lower measurement error was observed in sitting for adduction and in supine for abduction. This study shows that portable dynamometry can be used to concurrently measure hip adduction and abduction maximal and explosive strength, with levels of reliability that are similar to previously described methods.
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Affiliation(s)
- Basílio A M Gonçalves
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Ricardo N O Mesquita
- Center for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Francisco Tavares
- Medical and Performance Department, Sporting Clube de Portugal, Lisbon, Portugal
| | - João Brito
- Portugal Football School, Portuguese Football Federation, Oeiras, Portugal; and
| | - Paulo Correia
- Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Paulo Santos
- Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Pedro Mil-Homens
- Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
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Kazemkhani N, ShahAli S, Shanbehzadeh S. Comparison of Isometric Strength of the Trunk and Hip Muscle Groups in Female Athletes with and without Low Back Pain: A Cross-Sectional Study. Med J Islam Repub Iran 2022; 36:62. [PMID: 36128283 PMCID: PMC9448477 DOI: 10.47176/mjiri.36.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 06/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Low back pain (LBP) is a common musculoskeletal disorder in athletes. Reduced strength in hip and trunk muscles has been observed among non-athletes with low back pain. This study aimed to compare the strength of trunk and hip muscles between female athletes with and without LBP and to investigate strength association with disability level in female athletes with LBP. Methods: This cross-sectional study was conducted on 26 female athletes with LBP and 30 female athletes without LBP. The strength of the trunk and hip muscles was measured using a hand-held dynamometer and the impact of LBP on the sports activities and activities of daily living was measured using the Athletes Disability Index (ADI). Data analysis was done using an independent sample t test and the Pearson correlation coefficient. Results: There were no significant differences between groups for trunk and hip muscles strength (p > 0.05). A fair to moderate correlation was seen between the strength of the trunk, hip abductors, flexor and extensors muscles and the scores of the ADI questionnaire in the LBP group (r = -0.26 to -0.48). However, there was no significant correlation between the strength of hip adductor muscles and the scores on the ADI questionnaire. Conclusion: Based on the results, the strength of trunk and hip muscles was not different between athletes with and without LBP. It is recommended that athletes' training be done during functional tasks rather than strengthening a single muscle group.
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Affiliation(s)
- Niloufar Kazemkhani
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shabnam ShahAli
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran,Corresponding author: Dr Shabnam ShahAli,
| | - Sanaz Shanbehzadeh
- Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran
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Modulus of Elasticity of Elastic Tubes Used in Neuromuscular Rehabilitation Programs. J Sport Rehabil 2021; 31:362-367. [PMID: 34560663 DOI: 10.1123/jsr.2021-0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/16/2021] [Accepted: 06/23/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT The elastic tubes have been used for clinical rehabilitation programs in which exercises are performed with submaximal intensities due to the difficulty in the measure the applied force. The authors aimed to quantify the elastic constant of elastic tubes used in neuromuscular rehabilitation programs predicting the force related to elastic tube elongation. A force test was performed by stretching the elastic tubes to determine the relationship between force and elongation. Eight elastic tubes with progressive levels of resistance represented by colors (yellow, red, blue, gray, black, grape, purple, and gold-low to higher resistance) were used. DESIGN Experimental. METHODS The test and retest were compared using the paired t test. The agreement and reliability between the test versus retest of pooled means colors were analyzed by plotting the Bland-Altman graph and intraclass correlation coefficient and the coefficient of variation. Pearson correlation was used to verify the validity between measurements. RESULTS The force values generated from the elastic tube elongation increase according to the color and thickness of elastic tubes with a strong and significant association between them (P < .0001). The elastic constant measurements were similar and presented high intraclass correlation coefficient values, low coefficient of variation values, and were reproducible (P < .0001). CONCLUSIONS The force could be quantified according to elastic tube length variation by the linear regression equation with reproducibility. It gives greater measurement precision and better training load control when using elastic tubes in strength training programs.
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Reliability of a New Portable Dynamometer for Assessing Hip and Lower Limb Strength. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11083391] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Intrarater Test-Retest Reliability of Hip Abduction, Internal Rotation, and External Rotation Strength Measurements in a Healthy Cohort Using a Handheld Dynamometer and a Portable Stabilization Device: A Pilot Study. Arch Rehabil Res Clin Transl 2021; 2:100050. [PMID: 33543077 PMCID: PMC7853325 DOI: 10.1016/j.arrct.2020.100050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective To investigate the within-day and between-day test-retest reliability of hip abduction, internal rotation, and external rotation strength measurements taken using a portable device externally stabilizing a handheld dynamometer in healthy participants. Design Observational study. Setting Institute of Technology Carlow, Ireland, a third-level education institute. Participants Healthy participants (N=18; 11 male, 7 female) who participate in a field sport for more than 2 hours per week were recruited via convenience sampling. Interventions Not applicable. Main Outcome Measures Hip abduction, internal rotation, and external rotation peak force during a maximal voluntary isometric contraction (N). The 3 best values recorded for each movement for each day were used to analyze within-day and between-day test-retest reliability. Intraclass correlation coefficients (ICCs), coefficients of variance, standard error of measurement, and minimal detectable change statistics were also calculated. Results External fixation of a handheld dynamometer produced excellent test-retest reliability for within-day (ICC>0.934) and between-day (ICC>0.802) contexts. Conclusions Clinical measurements of hip strength can be performed reliably, efficiently, and cost effectively using the methods described. Furthermore, the use of external fixation eliminates the influence of tester strength on the handheld dynamometry measurements.
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Davey AP, Vacek PM, Caldwell RA, Slauterbeck JR, Gardner-Morse MG, Tourville TW, Beynnon BD. Risk Factors Associated With a Noncontact Anterior Cruciate Ligament Injury to the Contralateral Knee After Unilateral Anterior Cruciate Ligament Injury in High School and College Female Athletes: A Prospective Study. Am J Sports Med 2019; 47:3347-3355. [PMID: 31689130 PMCID: PMC9295727 DOI: 10.1177/0363546519886260] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The incidence of contralateral anterior cruciate ligament (CACL) injuries after recovery from a first-time anterior cruciate ligament (ACL) disruption is high in women; however, little is known about the risk factors associated with this trauma. HYPOTHESIS Patient characteristics, strength, anatomic alignment, and neuromuscular characteristics of the contralateral uninjured leg at the time of the first ACL trauma are associated with risk of subsequent CACL injury, and these risk factors are distinct from those for a first-time ACL injury. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS Sixty-one women who suffered a first-time noncontact ACL injury while participating in high school or college sports and underwent measurement of potential risk factors on their contralateral limb soon after the initial ACL injury and before reconstruction were followed until either a CACL injury or an ACL graft injury occurred, or until the last date of contact. RESULTS Follow-up information was available for 55 (90.0%) of the 61 athletes and 11 (20.0%) suffered a CACL injury. Younger age, decreased participation in sport before the first ACL disruption, decreased anterior stiffness of the contralateral knee, and increased hip anteversion were associated with increases in the risk of suffering a CACL injury. CONCLUSION A portion of CACL injury risk factors were modifiable (time spent participating in sport and increasing anterior knee stiffness with bracing), while others were nonmodifiable (younger age and increased hip anteversion). The relationship between younger age at the time of an initial ACL injury and increased risk of subsequent CACL trauma may be explained by younger athletes having more years available to be exposed to at-risk activities compared with older athletes. A decrease of anterior stiffness of the knee is linked to decreased material properties and width of the ACL, and this may explain why some women are predisposed to bilateral ACL trauma while others only suffer the index injury. The risk factors for CACL injury are unique to women who suffer bilateral ACL trauma compared with those who suffer unilateral ACL trauma. This information is important for the identification of athletes who may benefit from risk reduction interventions.
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Affiliation(s)
- Annabelle P. Davey
- McClure Musculoskeletal Research Center, Department of Orthopedics and Rehabilitation, Robert Larner M.D. College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Pamela M. Vacek
- Department of Medical Biostatistics, University of Vermont, Burlington, Vermont, USA
| | - Ryan A. Caldwell
- McClure Musculoskeletal Research Center, Department of Orthopedics and Rehabilitation, Robert Larner M.D. College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - James R. Slauterbeck
- McClure Musculoskeletal Research Center, Department of Orthopedics and Rehabilitation, Robert Larner M.D. College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Mack G. Gardner-Morse
- McClure Musculoskeletal Research Center, Department of Orthopedics and Rehabilitation, Robert Larner M.D. College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Timothy W. Tourville
- Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, University of Vermont, Burlington, Vermont, USA
| | - Bruce D. Beynnon
- McClure Musculoskeletal Research Center, Department of Orthopedics and Rehabilitation, Robert Larner M.D. College of Medicine, University of Vermont, Burlington, Vermont, USA.,Address correspondence to Bruce D. Beynnon, MS, PhD, McClure Musculoskeletal Research Center, Department of Orthopedics and Rehabilitation, Robert Larner M.D. College of Medicine, University of Vermont, Burlington, VT 05405-0084, USA ()
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Gittings PM, Hince DA, Wand BM, Wood FM, Edgar DW. Grip and Muscle Strength Dynamometry in Acute Burn Injury: Evaluation of an Updated Assessment Protocol. J Burn Care Res 2018; 39:939-947. [DOI: 10.1093/jbcr/iry010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Paul M Gittings
- Burn Service of Western Australia, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- Burn Injury Research Node, University of Notre Dame Australia, Fremantle, Western Australia, Australia
- The Fiona Wood Foundation, Murdoch, Western Australia, Australia
| | - Dana A Hince
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Benedict M Wand
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Fiona M Wood
- Burn Service of Western Australia, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- The Fiona Wood Foundation, Murdoch, Western Australia, Australia
- Burn Injury Research Unit, University of Western Australia, Crawley, Western Australia, Australia
| | - Dale W Edgar
- Burn Service of Western Australia, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- Burn Injury Research Node, University of Notre Dame Australia, Fremantle, Western Australia, Australia
- The Fiona Wood Foundation, Murdoch, Western Australia, Australia
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Jara CC, Ríos LJC, Mayorga DJ, Rios IC, Salazar CM, Beraldo PC. Comparison of two incremental protocols for evaluation of hip extension. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.001.ao14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: The hip muscles play an important role in controlling the transverse and frontal plane of the femur during displacement. The hip extension and abduction/adduction exercises are among the most widely evaluated protocols both clinically and in research. Objective: To compare which assessment protocol in an isokinetic strength regime (distal grip-ankle vs. proximal grip-knee) best represents the action of hip extension and to analyze the test-retest reliability in the variables peak force (PF) and work (W). Methods: A total of 20 subjects participated in this research. All participants were female. The mean and standard deviations of age, weight and height were 21 ± 3.9 years, 65 ± 11 kg, 166 ± 3.4 cm, respectively. Results: Significant differences were found in both variables (PF and W) between protocols 1 and 2 (p < 0.05) on assessment days 1 and 2. No differences between days 1 and day 2 in either protocol (p < 0.05) were found. Index values of interclass correlation (ICC) of protocol 1 ranged between 0.38 and 0.86. In protocol 2 the ICC range was between 0.33 and 0.87. Conclusions: In light of these results, the hip extension exercise with a proximal grip best represents the strength of the muscle groups involved in this action.
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Vacek PM, Slauterbeck JR, Tourville TW, Sturnick DR, Holterman LA, Smith HC, Shultz SJ, Johnson RJ, Tourville KJ, Beynnon BD. Multivariate Analysis of the Risk Factors for First-Time Noncontact ACL Injury in High School and College Athletes: A Prospective Cohort Study With a Nested, Matched Case-Control Analysis. Am J Sports Med 2016; 44:1492-501. [PMID: 27217522 PMCID: PMC6533630 DOI: 10.1177/0363546516634682] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Multivariate analysis that identifies the combination of risk factors associated with anterior cruciate ligament (ACL) trauma is important because it provides insight into whether a variable has a direct causal effect on risk or an indirect effect that is mediated by other variables. It can also reveal risk factors that might not be evident in univariate analyses; if a variable's effect is moderated by other variables, its association with risk may be apparent only after adjustment for the other variables. Most important, multivariate analyses can identify combinations of risk factors that are more predictive of risk than individual risk factors. HYPOTHESIS A diverse combination of risk factors predispose athletes to first-time noncontact ACL injury, and these relationships are different for male and female athletes. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS Athletes competing in organized sports at the high school and college levels participated in this study. Data from injured subjects (109 suffering an ACL injury) and matched controls (227 subjects) from the same athletic team were analyzed with multivariate conditional logistic regression to examine the effects of combinations of variables (demographic characteristics, joint laxity, lower extremity alignment, strength, and personality traits) on the risk of suffering their first ACL injury and to construct risk models. RESULTS For male athletes, increases in anterior-posterior displacement of the tibia relative to the femur (knee laxity), posterior knee stiffness, navicular drop, and a decrease in standing quadriceps angle were jointly predictive of suffering an ACL injury. For female athletes the combined effects of having a parent who had suffered an ACL injury and increases in anterior-posterior knee laxity and body mass index were predictive of ACL injury. CONCLUSION Multivariate models provided more information about ACL injury risk than individual risk factors. Both male and female risk models included increased anterior-posterior knee laxity as a predictor of ACL injury but were otherwise dissimilar.
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Affiliation(s)
- Pamela M Vacek
- Department of Medical Biostatistics, University of Vermont, Burlington, Vermont, USA
| | - James R Slauterbeck
- McClure Musculoskeletal Research Center, Department of Orthopaedics and Rehabilitation, University of Vermont, Burlington, Vermont, USA
| | - Timothy W Tourville
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
| | - Daniel R Sturnick
- McClure Musculoskeletal Research Center, Department of Orthopaedics and Rehabilitation, University of Vermont, Burlington, Vermont, USA
| | - Leigh-Ann Holterman
- Department of Medical Biostatistics, University of Vermont, Burlington, Vermont, USA
| | - Helen C Smith
- McClure Musculoskeletal Research Center, Department of Orthopaedics and Rehabilitation, University of Vermont, Burlington, Vermont, USA
| | - Sandra J Shultz
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Robert J Johnson
- McClure Musculoskeletal Research Center, Department of Orthopaedics and Rehabilitation, University of Vermont, Burlington, Vermont, USA
| | - Kelly J Tourville
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
| | - Bruce D Beynnon
- McClure Musculoskeletal Research Center, Department of Orthopaedics and Rehabilitation, University of Vermont, Burlington, Vermont, USA
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Kasser SL, Jacobs JV, Ford M, Tourville TW. Effects of balance-specific exercises on balance, physical activity and quality of life in adults with multiple sclerosis: a pilot investigation. Disabil Rehabil 2015; 37:2238-49. [DOI: 10.3109/09638288.2015.1019008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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