Evaluation of range of motion restriction within the hip joint.
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ABSTRACT:
SUBMITTER: Turley GA
PROVIDER: S-EPMC3589629 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Radiologically verified cam-type femoroacetabular impingement (FAI) has been shown to correlate with reduced internal rotation, reduced passive hip flexion, and a positive anterior impingement test.To validate how a clinical examination of the hip joint correlates with magnetic resonance imaging (MRI)-verified cam deformity in adolescents.Cross-sectional study; Level of evidence, 3.The sample group consisted of 102 adolescents with the mean age 17.7 ± 1.4 years. The hip joints were examined using MRI for measurements of the presence of cam (α-angle ≥55°) and clinically for range of motion (ROM) in both supine and sitting positions. The participants were divided into a cam and a noncam group based on the results of the MRI examination. Passive hip flexion, internal rotation, anterior impingement, and the FABER (flexion, abduction, and external rotation) test were used to test both hips in the supine position. With the participant sitting, the internal/external rotation of the hip joint was measured in 3 different positions of the pelvis (neutral, maximum anteversion, and retroversion) and lumbar spine (neutral, maximum extension, and flexion).Differences were found between the cam and noncam groups in terms of the anterior impingement test (right, P = .010; left, P = .006), passive supine hip flexion (right: mean, 5°; cam, 117°; noncam, 122° [P = .05]; and left: mean, 8.5°; cam, 116°; noncam, 124.5° [P = .001]), supine internal rotation (right: mean, 4.9°; cam, 24°; noncam, 29° [P = .022]; and left: mean, 4.8°; cam, 26°; noncam, 31° [P = .028]), sitting internal rotation with the pelvis and lumbar spine in neutral (right: mean, 7.95°; cam, 29°; noncam, 37° [P = .001]; and left: mean, 6.5°; cam, 31.5°; noncam, 38° [P = .006]), maximum anteversion of the pelvis and extension of the lumbar spine (right: mean, 5.2°; cam, 20°; noncam, 25° [P = .004]; and left: mean, 5.85°; cam, 20.5; noncam, 26.4° [P = .004]), and maximum retroversion of the pelvis and flexion of the spine (right: mean, 8.4°; cam, 32.5°; noncam, 41° [P = .001]; and left: mean, 6.2°; cam, 36°; noncam, 42.3° [P = .012]). The cam group had reduced ROM compared with the noncam group in all clinical ROM measures.The presence of cam deformity on MRI correlates with reduced internal rotation in the supine and sitting positions, passive supine hip flexion, and the impingement test in adolescents.
| S-EPMC5495502 | biostudies-other
Project description:BackgroundThe primary objectives of total hip arthroplasty (THA) include mobility improvement and pain relief; however, the correlation between hip range of motion (ROM) and function remains unclear. We aimed to explore how ROM affects hip functions after THA and compare the responsiveness of each component of the modified Harris Hip Score (mHHS) and Oxford Hip Score (OHS) to preoperative and postoperative ROM.MethodsThis prospective observational study involved 120 patients who underwent unilateral THA. Univariate regression analyses were performed using the University of California Los Angeles activity score and mHHS and OHS to determine the effects of preoperative and postoperative flex ROM on clinical scores at 12 months. Multivariate regressions were performed to adjust for the confounding effects of patient factors: age, sex, body mass index, and diagnosis.ResultsA larger preoperative flexion ROM was associated with a higher score in the mHHS socks component (standardized coefficient [SC] = 0.26, P = .0041) at 12 months; the effect on the OHS socks component was not significant (P = .34). A larger flexion ROM at 12 months was associated with higher scores in the mHHS support (SC = 0.21, P = .026), stairs (SC = 0.35, P = .0002), and socks (SC = 0.32, P = .0007) components but had no significant effect on any OHS component. The effects of ROM on University of California Los Angeles activity score were limited.ConclusionsA discrepancy was noted in the responsiveness to ROM between the two major measurement tools; this difference might be because mHHS and OHS are surgeon- and patient-administered questionnaires, respectively. This discrepancy also suggests that the patients have higher satisfaction than that assumed by the surgeons.
| S-EPMC8783107 | biostudies-literature
Project description:The use of wireless sensors to measure motion in non-laboratory settings continues to grow in popularity. Thus far, most validated systems have been applied to measurements in controlled settings and/or for prescribed motions. The aim of this study was to characterize adolescent hip joint motion of elite-level athletes (soccer players) during practice and recreationally active peers (controls) in after-school activities using a magneto-inertial measurement unit (MIMU) system. Opal wireless sensors (APDM Inc., Portland OR, USA) were placed at the sacrum and laterally on each thigh (three sensors total). Hip joint motion was characterized by hip acceleration and hip orientation for one hour of activity on a sports field. Our methods and analysis techniques can be applied to other joints and activities. We also provide recommendations in order to guide future work using MIMUs to pervasively assess joint motions of clinical relevance.
| S-EPMC7506643 | biostudies-literature
Project description:Objective:To evaluate the immediate effects of pragmatic posterior capsular stretch (PPCS) on shoulder joint range of motion (ROM). Method:A quasi-experimental design was used to recruit healthy subjects of age 21.43 (±1.960) years, height 165.8 (±2.1069) cm and weight 63.90 (±13.187) kg. Inclusion criteria were grade 1 and grade 2 of the shoulder mobility test of functional movement screening. Preintervention and postintervention measurement of flexion, abduction, internal rotation (IR), external rotation (ER), reaching up behind the back (RUBTB) and reaching down behind the neck (RDBTN) were compared. A therapist-administered PPCS was the only intervention applied. Results:Paired t-test statistics showed improvement (mean°±SD) in shoulder flexion (13.5°±8.11), abduction (11°±8.35), IR (8.5°±10.27), ER (7.83°±7.15), RUBTB (17.34°±13.81) inches and RDBTN (2.93±1.52) inches. The changes in these ROM and functional movements were statistically significant (p<0.05). Conclusion:PPCS can effectively improve the functional movement of RUBTB and shoulder ROM in healthy subjects. It is recommended for the trials on prevention and rehabilitation of shoulder pathologies. Trial registration number:NCT04242888.
| S-EPMC7520545 | biostudies-literature
Project description:Little is known about the construct validity of the Functional Movement Screen (FMS). We aimed to assess associations between FMS task scores and measures of maximum joint range-of-motion (ROM) among university varsity student-athletes from 4 sports (volleyball, basketball, ice hockey, and soccer). Athletes performed FMS tasks and had their maximum ankle, hip and shoulder ROM measured. Multivariable linear regression was used to estimate associations between FMS task scores and ROM measurements. 101 university student-athletes were recruited (52 W/49 M; mean age 20.4±1.9 years). In general, athletes with higher FMS task scores had greater ROM compared to those with lower task scores. For example, athletes who scored 2 on the FMS squat task had 4° (95% CI, 1° to 7°) more uni-articular ankle dorsiflexion ROM compared with those who scored 1, while those who scored 3 on the FMS squat task had 10° (4° to 17°) more uni-articular ankle dorsiflexion ROM compared with those who scored 1. Large variation in ROM measurements was observed. In sum, substantial overlap in joint ROM between groups of athletes with different FMS task scores weakens the construct validity of the FMS as an indicator of specific joint ROM.
| S-EPMC9200477 | biostudies-literature
Project description:Joint incongruity is often cited as a possible etiological factor for the high incidence of thumb carpometacarpal (CMC) joint osteoarthritis (OA) in older women. There is evidence suggesting that biomechanics plays a role in CMC OA progression, but little is known about how CMC joint congruence, specifically, differs among different cohorts. The purpose of this in vivo study was to determine if CMC joint congruence differs with sex, age, and early stage OA for different thumb positions. Using CT data from 155 subjects and a congruence metric that is based on both articular morphology and joint posture, we did not find any differences in CMC joint congruence with sex or age group, but found that patients in the early stages of OA exhibit lower congruence than healthy subjects of the same age group.
| S-EPMC5544917 | biostudies-other
Project description:Large-size hip articulations may improve range of motion (ROM) and function compared to a 28-mm THA, and the low risk of dislocation allows the patients more activity postoperatively. On the other hand, the greater extent of surgery for resurfacing hip arthroplasty (RHA) could impair rehabilitation. We investigated the effect of head size and surgical procedure on postoperative rehabilitation in a randomized clinical trial (RCT). Methods We followed randomized groups of RHAs, large-head THAs and standard THAs at 2 months, 6 months, 1 and 2 years postoperatively, recording clinical rehabilitation parameters.Large articulations increased the mean total range of motion by 13° during the first 6 postoperative months. The increase was not statistically significant and was transient. The 2-year total ROM (SD) for RHA, standard THA, and large-head THA was 221° (35), 232° (36), and 225° (30) respectively, but the differences were not statistically significant. The 3 groups were similar regarding Harris hip score, UCLA activity score, step rate, and sick leave.Head size had no influence on range of motion. The lack of restriction allowed for large articulations did not improve the clinical and patient-perceived outcomes. The more extensive surgical procedure of RHA did not impair the rehabilitation. This project is registered at ClinicalTrials.gov under # NCT01113762.
| S-EPMC3715815 | biostudies-literature
Project description:BackgroundThere is a complex interaction among acetabular component position and antetorsion of the femoral stem in determining the maximum, impingement-free prosthetic range-of-motion (ROM) in total hip arthroplasty (THA). By insertion into the femoral canal, stems of any geometry follow the natural anterior bow of the proximal femur, creating a sagittal Femoral Tilt (FT). We sought to study the incidence of FT as measured on postoperative computed tomography scans and its influence on impingement-free ROM in THA.MethodsThe incidence of the postoperative FT was evaluated on 40 computed tomography scans after cementless THA. With the help of a three-dimensional computer model of the hip, we then systematically analyzed the effects of FT on femoral antetorsion and its influence on calculations for a ROM maximized and impingement-free compliant stem/cup orientation.ResultsThe mean postoperative FT on CT scans was 5.7° ± 1.8°. In all tests, FT significantly influenced the antetorsion values. Re-calculating the compliant component positions according to the concept of combined anteversion with and without the influence of FT revealed that the zone of compliance could differ by more than 200%. For a 7° change in FT, the impingement-free cup position differed by 4° for inclination when the same antetorsion was used.ConclusionsA range-of-motion optimized cup position in THA cannot be calculated based on antetorsion values alone. The FT has a significant impact on recommended cup positions within the concept of "femur first" or "combined anteversion". Ignoring FT may pose an increased risk of impingement as well as dislocation.
| S-EPMC3416712 | biostudies-literature
Project description:In total hip arthroplasty, aseptic loosening and dislocation are associated with not being able to achieve the correct prosthetic component orientation. Femoral neck modularity has been proposed as a solution to this problem by allowing the surgeon to alter either the neck-shaft or version angle of the prosthetic femoral component intra-operatively. A single replicate full factorial design was used to evaluate how effective a modular femoral neck cementless stem was in restoring a healthy prosthetic range of motion in comparison with a leading fixed-neck cementless stem with the standard modular parameters. It was found that, if altered to a large enough degree, femoral neck modularity can increase the amount of prosthetic motion as well as alter its position to where it is required physiologically. However, there is a functional limit to the amount that can be corrected and there is a risk with regard to the surgeon having to select the optimum modular neck before any benefit is realised.
| S-EPMC4102828 | biostudies-literature
Project description:BackgroundIn clinical practice range of motion (RoM) is usually assessed with low-cost devices such as a tape measure (TM) or a digital inclinometer (DI). However, the intra- and inter-rater reliability of typical RoM tests differ, which impairs the evaluation of therapy progress. More objective and reliable kinematic data can be obtained with the inertial motion capture system (IMC) by Xsens. The aim of this study was to obtain the intra- and inter-rater reliability of the TM, DI and IMC methods in five RoM tests: modified Thomas test (DI), shoulder test modified after Janda (DI), retroflexion of the trunk modified after Janda (DI), lateral inclination (TM) and fingertip-to-floor test (TM).MethodsTwo raters executed the RoM tests (TM or DI) in a randomized order on 22 healthy individuals while, simultaneously, the IMC data (Xsens MVN) was collected. After 15 warm-up repetitions, each rater recorded five measurements.FindingsIntra-rater reliabilities were (almost) perfect for tests in all three devices (ICCs 0.886-0.996). Inter-rater reliability was substantial to (almost) perfect in the DI (ICCs 0.71-0.87) and the IMC methods (ICCs 0.61-0.993) and (almost) perfect in the TM methods (ICCs 0.923-0.961). The measurement error (ME) for the tests measured in degree (°) was 0.9-3.3° for the DI methods and 0.5-1.2° for the IMC approaches. In the tests measured in centimeters the ME was 0.5-1.3cm for the TM methods and 0.6-2.7cm for the IMC methods. Pearson correlations between the results of the DI or the TM respectively with the IMC results were significant in all tests except for the shoulder test on the right body side (r = 0.41-0.81).InterpretationMeasurement repetitions of either one or multiple trained raters can be considered reliable in all three devices.
| S-EPMC7728246 | biostudies-literature