Comparison of gluteus medius strength between individuals with obesity and normal-weight individuals: a cross-sectional study

Altered lumbo-pelvic-hip complex muscle morphometry and contraction change in postpartum pelvic girdle pain and asymptomatic subjects: a cross-sectional study

Objective

Lumbo-pelvic-hip complex muscle training is considered a crucial component of exercise rehabilitation for postpartum women with pelvic girdle pain (PGP). However, there is a paucity of research evidence regarding the morphological changes and contraction function of these muscles in postpartum women with PGP. Understanding the alterations in lumbo-pelvic-hip complex muscles function associated with PGP, is crucial for tailoring effective rehabilitation strategies and promoting optimal postpartum recovery. Therefore, this study aims to compare the differences in muscle thickness and contraction function of lumbo-pelvic-hip complex muscle between postpartum women with PGP and asymptomatic controls using ultrasound imaging.

Methods

One hundred and fifty postpartum women with PGP and fifty age-matched asymptomatic postpartum women were recruited in this study. Real-time musculoskeletal ultrasound was utilized to measure the resting muscle thickness of nine lumbo-pelvic-hip complex muscles, including the erector spinalis (ES), latissimus dorsi (LD), quadratus lumbalis (QL), gluteus maximus (GMax), gluteus medius (GMed), piriformis (PF), iliacus muscle (IM), rectus femoris (RF), and biceps femoris (BF). The thickness of the GMax, GMed, RF, and BF muscles were measured at maximum contraction to calculate a contraction: rest ratio.

Results

Compared to the asymptomatic women, those with PGP exhibited reduced resting thickness of the ES and GMax muscles bilaterally, as well as increased resting thickness of the right LD and IM muscles. Furthermore, the PGP group demonstrated decreased thickness of the left GMed and right RF muscles at maximum contraction. The contraction ratio was also diminished for the GMax muscles bilaterally, left GMed, and right RF in women with postpartum PGP. Conclusion: Postpartum women with PGP demonstrated reduced thickness, asymmetry, and diminished contractility of the lumbo-pelvic-hip complex muscles. Exercise prescriptions for postpartum women with PGP should incorporate targeted strengthening of the ES, GMax, GMed, and RF muscles.

Conclusion

Postpartum women with PGP demonstrated reduced thickness, asymmetry, and diminished contractility of the lumbo-pelvic-hip complex muscle. Exercise prescriptions for postpartum women with PGP should incorporate targeted strengthening of the ES, GMax, GMed, and RF muscles.

Comparative Efficacy of Quadratus Lumborum Muscle Energy Technique with Gluteus Medius Strengthening Versus Gluteus Medius Strengthening Alone in Sacroiliac Joint Dysfunction: A Randomized Controlled Trial

BACKGROUND

Pain in the sacroiliac joint is the most prevalent and often overlooked. The sacroiliac joints are thought to be sources of pain in roughly 10% to 25% of patients with chronic lower back pain. Due to the biomechanical nature of the joint, muscle imbalance is the most important cause of sacroiliac joint dysfunction. The hamstring and gluteus medius are the primary muscles involved in postural dysfunction-related muscle imbalance; however, the quadratus lumborum's role in the compensatory mechanism is becoming more apparent, and its potential for treatment in conjunction with gluteus medius strengthening has not yet been investigated. Gluteus medius exercises, along with conventional treatment, are routinely given to patients with sacroiliac joint dysfunction; however, the aim of this study is to explore the additional effects of the muscle energy technique (MET) on the quadratus lumborum along with strengthening of the gluteus medius on pain, disability and quality of life of patients with sacroiliac joint dysfunction.

METHODS

Using a computer-generated random number table, seventy patients with unilateral sacroiliac joint pain were divided equally and randomly into two groups. Prior to initiating treatment, baseline measurements were taken using a hand-held dynamometer, visual analog scale (VAS), Oswestry Disability Index (ODI-U) and short form 36-item survey (SF-36v2) to assess strength, pain, functional disability and quality of life, respectively. Over the course of four weeks, all patients received twelve sessions, and both the pre- and post-intervention outcome measures were documented.

RESULTS

After 4 weeks of treatment, both groups showed statistically significant (p < 0.005) mean improvements in muscle strength, pain, disability and quality of life before and after intervention. However, the mean improvements in post-intervention on a dynamometer, VAS, ODI and SF-36 were better in the MET with exercise group (METGME) as compared to the conventional group with exercise (CTGME), with a larger effect size.

CONCLUSIONS

The muscle energy technique, applied to the quadratus lumborum in combination with gluteus medius strengthening, is more effective clinically and significantly in improving pain, disability and quality of life in comparison to conventional treatment of sacroiliac joints with gluteus medius exercises.

Influences of cognitive load on center of pressure trajectory of young male adults with excess weight during gait initiation

Introduction: Falls and fall-related injuries in young male adults with excess weight are closely related to an increased cognitive load. Previous research mainly focuses on analyzing the postural control status of these populations performing cognitive tasks while stabilized walking progress but overlooked a specific period of walking known as gait initiation (GI). It is yet unknown the influences of cognitive load on this population's postural control status during GI. Objective: This study aimed to determine the influences of cognitive load on the center of pressure (CoP) trajectory of young male adults with excess weight during GI. Design: A controlled laboratory study. Methods: Thirty-six male undergraduate students were recruited and divided into normal-weight, overweight, and obese groups based on their body mass index (BMI). Participants' CoP parameters during GI under single and dual-task conditions were collected by two force platforms. A mixed ANOVA was utilized to detect significant differences. Results: Compared with the normal-weight group, the obese group showed significant changes in the duration and CoP parameters during sub-phases of GI, mainly reflecting prolonged duration, increased CoP path length, higher mediolateral CoP displacement amplitude, and decreased velocity of anteroposterior CoP displacement. During GI with 1-back task, significantly increased mediolateral CoP displacement amplitude occurred in the obese group. During GI with 2-back task, the obese group had increased CoP path length, higher mediolateral CoP displacement amplitude, as well as a decreased velocity of CoP displacement. Conclusion: Based on the changes in CoP parameters during GI with cognitive tasks, young male adults with excess weight, mainly obese ones, have compromised postural stability. During GI with a difficult cognitive task, obese young male adults are more susceptible to deterioration in their lateral postural balance. These findings indicate that the increased cognitive load could exacerbate obese young male adults' postural control difficulty during GI under dual-task conditions, putting them at a higher risk of experiencing incidents of falls. Based on these findings, we offer suggestions for therapists to intervene with these young male adults to ensure their safety of GI.

Principal Component Analysis of Whole-Body Kinematics Using Markerless Motion Capture During Static Balance Tasks

Balance tests have clinical utility in identifying balance deficits and supporting recommendations for appropriate treatments. Motion capture technology can be used to measure whole-body kinematics during balance tasks, but to date the high technical and financial costs have limited uptake of traditional marker-based motion capture systems for clinical applications. Markerless motion capture technology using standard video cameras has the potential to provide whole-body kinematic assessments with clinically accessible technology. Our aim was to quantify poses and movement strategies during static balance tasks (tandem stance, single limb stance, standing hip abduction, and quiet standing on foam with eyes closed) using video-based markerless motion capture software (Theia3D) and principal component analysis to examine the associations with age, body mass index (BMI) and sex. In 30 healthy adults, the mean poses for all balance tasks had at least one principal component (PC) that differed significantly by sex. Age was significantly associated with the PC describing leg height for the hip abduction task and erect posture for the quiet standing task. BMI was significantly associated with the PC capturing knee flexion in the single leg stance task. The movement strategies used to maintain balance showed significant differences by sex for the tandem stance pose. BMI was correlated with PCs for movement strategies for hip abduction and quiet standing tasks. Results from this study demonstrate how markerless motion capture technology could be used to augment analyses of balance both in the clinic and in the field.