Dataset Information

In Vivo Measurements of the Ischiofemoral Space in Recreationally Active Participants During Dynamic Activities: A High-Speed Dual Fluoroscopy Study.

ABSTRACT:

Background

Ischiofemoral impingement (IFI) is a dynamic process, but its diagnosis is often based on static, supine images.

Purpose

To couple 3-dimensional (3D) computed tomography (CT) models with dual fluoroscopy (DF) images to quantify in vivo hip motion and the ischiofemoral space (IFS) in asymptomatic participants during weightbearing activities and evaluate the relationship of dynamic measurements with sex, hip kinematics, and the IFS measured from axial magnetic resonance imaging (MRI).

Study design

Cross-sectional study; Level of evidence, 3.

Methods

Eleven young, asymptomatic adults (5 female) were recruited. 3D reconstructions of the femur and pelvis were generated from MRI and CT. The axial and 3D IFS were measured from supine MRI. In vivo hip motion during weightbearing activities was quantified using DF. The bone-to-bone distance between the lesser trochanter and ischium was measured dynamically. The minimum and maximum IFS were determined and evaluated against hip joint angles using a linear mixed-effects model.

Results

The minimum IFS occurred during external rotation for 10 of 11 participants. The IFS measured from axial MRI (mean, 23.7 mm [95% CI, 19.9-27.9]) was significantly greater than the minimum IFS observed during external rotation (mean, 10.8 mm [95% CI, 8.3-13.7]; P < .001), level walking (mean, 15.5 mm [95% CI, 11.4-19.7]; P = .007), and incline walking (mean, 15.8 mm [95% CI, 11.6-20.1]; P = .004) but not for standing. The IFS was reduced with extension (β = 0.66), adduction (β = 0.22), and external rotation (β = 0.21) ( P < .001 for all) during the dynamic activities observed. The IFS was smaller in female than male participants for standing (mean, 20.9 mm [95% CI, 19.3-22.3] vs 30.4 mm [95% CI, 27.2-33.8], respectively; P = .034), level walking (mean, 8.8 mm [95% CI, 7.5-9.9] vs 21.1 mm [95% CI, 18.7-23.6], respectively; P = .001), and incline walking (mean, 9.1 mm [95% CI, 7.4-10.8] vs 21.3 mm [95% CI, 18.8-24.1], respectively; P = .003). Joint angles between the sexes were not significantly different for any of the dynamic positions of interest.

Conclusion

The minimum IFS during dynamic activities was smaller than axial MRI measurements. Compared with male participants, the IFS in female participants was reduced during standing and walking, despite a lack of kinematic differences between the sexes. The relationship between the IFS and hip joint angles suggests that the hip should be placed into greater extension, adduction, and external rotation in clinical examinations and imaging, as the IFS measured from static images, especially in a neutral orientation, may not accurately represent the minimum IFS during dynamic motion. Nevertheless, this statement must be interpreted with caution, as only asymptomatic participants were analyzed herein.

SUBMITTER: Atkins PR

PROVIDER: S-EPMC6599761 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Publications

In Vivo Measurements of the Ischiofemoral Space in Recreationally Active Participants During Dynamic Activities: A High-Speed Dual Fluoroscopy Study.

Atkins Penny R PR Fiorentino Niccolo M NM Aoki Stephen K SK Peters Christopher L CL Maak Travis G TG Anderson Andrew E AE

The American journal of sports medicine 20170706 12

<h4>Background</h4>Ischiofemoral impingement (IFI) is a dynamic process, but its diagnosis is often based on static, supine images.<h4>Purpose</h4>To couple 3-dimensional (3D) computed tomography (CT) models with dual fluoroscopy (DF) images to quantify in vivo hip motion and the ischiofemoral space (IFS) in asymptomatic participants during weightbearing activities and evaluate the relationship of dynamic measurements with sex, hip kinematics, and the IFS measured from axial magnetic resonance i ...[more]

PMID: 28682639

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Project description:Purpose: To use a novel in vivo method to simulate a moving hip model. Then, measure the dynamic bone-to-bone distance, and analyze the ischiofemoral space (IFS) of patients diagnosed with ischiofemoral impingement syndrome (IFI) during dynamic activities. Methods: Nine healthy subjects and 9 patients with IFI were recruited to collect MRI images and motion capture data. The motion trail of the hip during motion capture was matched to a personalized 3D hip model reconstructed from MRI images to get a dynamic bone model. This personalized dynamic in vivo method was then used to simulate the bone motion in dynamic activities. Validation was conducted on a 3D-printed sphere by comparing the calculated data using this novel method with the actual measured moving data using motion capture. Moreover, the novel method was used to analyze the in vivo dynamic IFS between healthy subjects and IFI patients during normal and long stride walking. Results: The validation results show that the root mean square error (RMSE) of slide and rotation was 1.42 mm/1.84° and 1.58 mm/2.19°, respectively. During normal walking, the in vivo dynamic IFS was significantly larger in healthy hips (ranged between 15.09 and 50.24 mm) compared with affected hips (between 10.16 and 39.74 mm) in 40.27%-83.81% of the gait cycle (p = 0.027). During long stride walking, the in vivo dynamic IFS was also significantly larger in healthy hips (ranged between 13.02 and 51.99 mm) than affected hips (between 9.63 and 44.22 mm) in 0%-5.85% of the gait cycle (p = 0.049). Additionally, the IFS of normal walking was significantly smaller than long stride walking during 0%-14.05% and 85.07%-100% of the gait cycle (p = 0.033, 0.033) in healthy hips. However, there was no difference between the two methods of walking among the patients. Conclusions: This study established a novel in vivo method to measure the dynamic bone-to-bone distance and was well validated. This method was used to measure the IFS of patients diagnosed with IFI, and the results showed that the IFS of patients is smaller compared with healthy subjects, whether in normal or long stride walking. Meanwhile, IFI eliminated the difference between normal and long stride walking.

Project description:BackgroundIndividuals are thought to compensate for femoral anteversion by altering hip rotation. However, the relationship between hip rotation in a neutral position (i.e. static rotation) and dynamic hip rotation is poorly understood, as is the relationship between anteversion and hip rotation.Research objectiveHerein, anteversion and in-vivo hip rotation during standing, walking, and pivoting were measured in eleven asymptomatic, morphologically normal, young adults using three-dimensional computed tomography models and dual fluoroscopy.MethodsUsing correlation analyses, we: 1) determined the relationship between hip rotation in the static position to that measured during dynamic activities, and 2) evaluated the association between femoral anteversion and hip rotation during dynamic activities. Hip rotation was calculated while standing (static-rotation), throughout gait, as a mean during gait (mean gait rotation), and as a mean (mid-pivot rotation), maximum (max-rotation) and minimum (min-rotation) during pivoting.ResultsStatic-rotation (mean ± standard deviation; 11.3° ± 7.3°) and mean gait rotation (7.8° ± 4.7°) were positively correlated (r = 0.679, p = 0.022). Likewise, static-rotation was strongly correlated with mid-pivot rotation (r = 0.837, p = 0.001), max-rotation (r = 0.754, p = 0.007), and min-rotation (r = 0.835, p = 0.001). Strong positive correlations were found between anteversion and hip internal rotation during all of the stance phase (0-60% gait) and during mid- and terminal-swing (86-100% gait) (all r > 0.607, p < 0.05).ConclusionsOur results suggest that the static position may be used cautiously to express the neutral rotational position of the femur for dynamic movements. Further, our results indicate that femoral anteversion is compensated for by altering hip rotation. As such, both anteversion and hip rotation may be important to consider when diagnosing hip pathology and planning for surgical procedures.

Project description:BackgroundSeveral multi-segment foot models have been developed to evaluate foot and ankle motion using skin-marker motion analysis. However, few multi-segment models have been evaluated against a reference standard to establish kinematic accuracy.Research questionHow accurately do skin-markers estimate foot and ankle motion for the modified Shriners Hospitals for Children Greenville (mSHCG) multi-segment foot model when compared against the reference standard, dual fluoroscopy (DF), during gait, in asymptomatic participants?MethodsFive participants walked overground as full-body skin-marker trajectory data and DF images of the foot and shank were simultaneously acquired. Using the mSHCG model, ankle and midfoot angles were calculated throughout stance for both motion analysis techniques. Statistical parametric mapping assessed differences in joint angles and marker positions between skin-marker and DF motion analysis techniques. Paired t tests, and linear regression models were used to compare joint angles and range of motion (ROM) calculated from the two techniques.ResultsIn the coronal plane, the skin-marker model significantly overestimated ROM (p = 0.028). Further, the DF model midfoot ROM was significantly positively related to differences between DF and skin-marker midfoot angles (p = 0.035, adjusted R2 = 0.76). In the sagittal plane, skin-markers underestimated ankle angles by as much as 7.26°, while midfoot angles were overestimated by as much as 9.01°. However, DF and skin-marker joint angles were not significantly different over stance. Skin-markers on the tibia, calcaneus, and fifth metatarsal had significantly different positions than the DF markers along the direction of walking for isolated portions that were less than 10 % of stance. Euclidean distances between DF and skin-markers positions were less than 9.36 mm.SignificanceAs the accuracy of the mSHCG model was formerly unknown, the results of this study provide ranges of confidence for key angles calculated by this model.

Dataset Information

In Vivo Measurements of the Ischiofemoral Space in Recreationally Active Participants During Dynamic Activities: A High-Speed Dual Fluoroscopy Study.

Background

Purpose

Study design

Methods

Results

Conclusion

Publications

In Vivo Measurements of the Ischiofemoral Space in Recreationally Active Participants During Dynamic Activities: A High-Speed Dual Fluoroscopy Study.

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