Roller Massage: Comparing the Immediate Post‐Treatment Effects Between an Instructional Video and a Self‐Preferred Program Using Two Different Density‐Type Roller Balls

Groin pain and hip range of motion is different in Indigenous compared to non-Indigenous young Australian football players

Changes in Shoulder Rotation Based on Elevation in Children With Brachial Plexus Birth Injury

Objective: The objective of this study was to provide normative data on pressure and thermal pain thresholds at several sites in the forequarter of normal subjects, as a basis for further studies investigating mechanical and thermal hyperalgesia in patients with chronic musculoskeletal disorders affecting the upper limb. The aims of the study included: determining whether there is any laterality effect on pain threshold, determining whether there is any proximal to distal variation in pain thresholds and determining whether there is any gender difference in pain thresholds. Methods: Subjects for this study were 20 normal volunteers in the age range 35-60. There was preponderance of female volunteers to reflect the preponderance of females in this age group who report chronic musculoskeletal pain. Pressure pain thresholds and thermal pain thresholds were measured bilaterally at seven sites in the forequarter. These sites were selected because they are common sites of tenderness associated with a variety of musculoskeletal disorders. Pressure pain thresholds were measures using a pressure algometer and thermal pain thresholds were measured using a contact thermode values were subjected to statistical analysis. Results: No differences between sides were seen for either pressure pain thresholds or thermal pain thresholds. The results obtained showed a significant site effect [P < 0.001] for pressure pain thresholds, although this was primarily due to the fact that values obtained for point 1 [anterior aspect of the transverse process of C6] were significantly lower than all other sites. There was no significant difference between sites for thermal pain thresholds although there was a tendency for 1 site to have a lower threshold than the other sites. For both measures, there was a distinct gender difference with females exhibiting significantly lower pressure pain thresholds [P < 0.036] and thermal pain thresholds [P < 0.05] than males. Conclusion: Normative data have been obtained for mechanical and thermal pain thresholds in a relevant subject population. These data may be used as a basis for further studies to investigate the generalized nature of altered pain thresholds in patients with chronic musculoskeletal disorders.

Background:There is a renewed interest in examining the association between hip range of motion and injury in athletes, and the data on baseball players are conflicting. Understanding whether asymmetrical hip rotation is a normal adaptation or a risk factor for injury will help therapists, trainers, and physicians develop rehabilitation programs to improve kinetic energy transfer and prevent injury. As our knowledge of hip pathology among baseball pitchers improves, establishing baselines for hip motion is critical in the further assessment of injury.Hypothesis:Because of the repetitive nature of throwing sports and the adaptive changes documented in the shoulder, elite baseball pitchers would have characteristic patterns of hip internal and external rotations on their dominant throwing side (stance) and their nondominant side (stride) in extension.Study Design:Cross-sectional study; Level of evidence, 3.Methods:Computer software was used to measure passive internal and external rotations on digital photographs of 111 professional baseball pitchers.Results:In right-handed pitchers, there was significantly more internal rotation in the stance hip than the stride hip (32.2° ± 8.2° vs 30.8° ± 8.4°; P = .0349) and significantly more external rotation in the stride hip than the stance hip (36.3° ± 7.7° vs 30.8° ± 9.7°; P < .0001). While the mean difference in external rotation was 4.7°, 32% of the subjects had a >10° increase in external rotation on the stride hip relative to the stance hip. This population was statistically different from the remaining group for older age (P = .0053), lower body mass index (P = .0379), and more years in professional baseball (P = .0328). In the smaller number of left-handed pitchers, side-to-side differences in hip rotation were found but were not statistically significant.Conclusion:Pitchers showed more internal rotation on their stance hip and more external rotation on their stride hip. Although the mean differences are small, there is a subset of pitchers with defined characteristics in whom larger differences exist.

Pain is a prevalent and debilitating healthcare problem. Since pharmacological treatments have numerous side-effects, additional treatment could be beneficial. Music has been shown to affect the pain perception and the pain threshold. The objective of this observational study was to evaluate the effect of preferred music as opposed to disliked music on pain (tolerance) thresholds and perceived pain intensity in healthy volunteers. Pain thresholds were measured via quantitative sensory testing. The volunteers were randomly assigned to either handheld pressure algometry to assess the pressure pain threshold to or electrical measurements to assess the electrical pain tolerance threshold while listening to preferred and disliked music. The pain thresholds were administered on the dorsal side of the forearm. The perceived pain intensity was assessed via a numerical rating scale, ranging from 0 (no pain) to 10 (worst pain imaginable). In total 415 volunteers were included in this study. The pressure pain threshold was assessed in 277 volunteers and in the electrical pain tolerance threshold test 138 volunteers were entered. In both groups, preferred music yielded higher pain thresholds than disliked music (P<0.001) and lower perceived pain intensity during the stimulus (P = 0.003). Moreover, the highest pain thresholds of both pressure pain and electrical pain tolerance thresholds were obtained when the preferred music was preceded by disliked music. Listening to preferred music when receiving noxious stimuli leads to higher pain thresholds and lower perceived pain scores in comparison with disliked music. Preferred music could be beneficial for patients with pain or undergoing painful procedures.

PurposeGreater femoral internal rotation (via anteversion or passive hip ROM) is associated with knee biomechanics thought to contribute to anterior cruciate ligament (ACL) injury, but it is unknown if femoral internal rotation contributes to actual ACL injury occurrence. The objective of this systematic review and meta-analysis was to quantify the extent to which femoral anteversion and hip range of motion (ROM) influence knee biomechanics consistent with ACL injury and actual ACL injury occurrence.MethodsUsing PRISMA guidelines, PubMed, CINAHL, SportDiscus, and Scopus databases were searched. Inclusion criteria were available passive hip ROM or femoral anteversion measure, ACL injury OR biomechanical analysis of functional task. Two reviewers independently reviewed titles, abstracts, and full texts when warranted. Included studies were submitted to Downs & Black Quality Assessment Tool. Meta-analyses were conducted for comparisons including at least two studies.ResultsTwenty-three studies were included (11 injury outcome, 12 biomechanical outcome). Decreased internal rotation ROM was significantly associated with history of ACL injury (MD -5.02°; 95% CI [-8.77°—-1.27°]; p = 0.01; n = 10). There was no significant effect between passive external rotation and ACL injury (MD -2.62°; 95% CI [-5.66°—- 0.41°]; p = 0.09; n = 9) Participants displaying greater frontal plane knee projection angle had greater passive external rotation (MD 4.77°; 95% CI [1.17° – 8.37°]; p = 0.01; n = 3). There was no significant effect between femoral anteversion and ACL injury (MD -0.46°; 95% CI [-2.23°—1.31°]; p = 0.61; n = 2). No within-sex differences were observed between injured and uninjured males and females (p range = 0.09 – 0.63).ConclusionThough individuals with injured ACLs have statistically less passive internal and external rotation, the observed heterogeneity precludes generalizability. There is no evidence that femoral anteversion influences biomechanics or ACL injury. Well-designed studies using reliable methods are needed to investigate biomechanical patterns associated with more extreme ROM values within each sex, and their prospective associations with ACL injury.Level of evidence: IV.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40634-022-00479-7.

INTRODUCTION: Objective measurements of hip range of motion (ROM) are used to determine both the treatment and outcomes of various hip disorders. Goniometers or inclinometers can be used to assess hip ROM, but little is known about the comparability of ROM measured with these devices. PURPOSE: We investigated the reliability of hip ROM measures obtained on goniometers and inclinometers among the same subjects. METHODS: Twelve medical school students ages 22-35 years and without hip pathology were recruited. The raters were three physical therapists experienced with using a goniometer and inclinometer. Active flexion, extension, internal and external rotation measurements of the right hip were obtained first with a goniometer and then with an inclinometer on each subject, and repeated later on the same day. Inter-rater and intra-rater reliability was determined with intraclass correlation coefficients (ICCs) on goniometers (ICCG) and inclinomters (ICCI) computed using PROC GLM in SAS 9.1.3. ICCs of 0.75 indicate excellent reliability. RESULTS: For flexion, the means (sd) assessed with the goniometer among raters 1-3, respectively, were 3.3 (11.1), 1.9 (3.6) and 2.8 (2.3) and with the inclinometer were 1.3 (6.7), 1.0 (11.6) and 1.3 (8.6). Patterns of between-rater variation were also observed for extension and internal and external rotation. Inter-rater reliability for hip flexion and external rotation measured with the goniometer and the inclinometer were good to excellent for flexion (ICCG=0.73, ICCI=0.79) and for external rotation (ICCG=0.91, ICCI=0.90). Inter-rater reliability was poor for hip extension (ICCG=0.50, ICCI=0.47) and internal rotation (ICCG=0.59, ICCI=0.60). Intra-rater reliability demonstrated a similar pattern being greatest for flexion (ICCG=0.82, ICCI=0.83) and external rotation (ICCG=0.96, ICCI=0.91), and poorer for extension (ICCG=0.54, ICCI=0.48) and internal rotation (ICCG=0.56, ICCI=0.64). CONCLUSION: The goniometer and inclinometer were similar in inter- and intra-rater reliability for all four hip ROM measures. However, neither instrument was particularly reliable in measuring extension or internal rotation. Standardized methods for measuring hip ROM in certain planes should be developed to improve reliability of these important clinical assessments.

It is generally believed that acetabular dysplasia (AD) is associated with increased hip range of motion (ROM). The purpose of this study was to investigate the associations between dysplasia severity and hip ROM in a large multicenter cohort. A prospective registry of patients undergoing periacetabular osteotomy for symptomatic AD by 1 of 13 surgeons was used to analyze 1,051 patients (mean age, 26 ± 10 years). Multivariable linear regression modeling was used to investigate for associations between dysplasia severity (severe, <5°; moderate, 5° to 15°; mild, >15°), α angle, and hip ROM. When controlling for age, sex, body mass index, and α angle, only internal (α = 1.94; P = 0.005) and external (α = -2.63; P < 0.001) rotation in extension were significantly different between groups with increasing dysplasia severity. Alpha angle was greater for those with severe AD compared with subjects with mild disease (60° ± 16° versus 57° ± 15°; P = 0.038). Alpha angle was also significantly correlated with rotational ROM parameters (internal and external rotation in flexion and extension) (Pearson r, range: -0.077 to -0.216; P < 0.05 for all), but not with linear motion. Internal rotation in extension was directly associated with dysplasia severity, whereas external rotation in extension was inversely associated. Furthermore, α angle was greater with increasing dysplasia severity and predictive of rotational ROM parameters. Taken together, these data suggest that femoral-sided deformity, including α angle and possibly femoral version, may be responsible for differences in ROM based on dysplasia severity. Level III, Prognostic.

What is the influence of biomechanical variables on the Y balance test performance in recreational runners?

Abnormal range of motion (ROM) is a common sign of pathology in the pediatric hip, yet there are little data in the literature defining what the normal hip ROM is in children. The purpose of this study was to establish normative values for hip ROM in children of varying ages. We performed an Institutional Review Board approved, prospective study of otherwise healthy patients receiving fracture care at our institution. Inclusion criteria were boys and girls aged 2 to 17, who were being treated for an isolated upper extremity injury and who had no underlying musculoskeletal condition, history of lower extremity injury, or other systemic diagnosis. All patients were evaluated with a standard measurement technique using the same double-long-armed goniometer. Supine abduction, adduction, and hip flexion were measured with care taken to stabilize the pelvis. Internal and external rotation in flexion were assessed with both the hip and knee flexed to 90 degrees. In the prone position, hip extension was recorded as was internal and external rotation in extension. Left and right measurements were averaged to produce a single data point for each index. On the basis of a power analysis (to detect a minimal detectable difference of 6 degrees), 2 separate cohorts of 23 patients were randomly selected for the assessment of intraobserver and interobserver reliability. We measured 504 hips in 252 pediatric patients, including 163 boys and 89 girls. We found a decreasing trend in ROM for almost all indices with advancing age, although this decline was less apparent among girls. Intraobserver reliability demonstrated excellent agreement (intra class correlation coefficient>0.81) for all indices. Interobserver assessments revealed excellent agreement for abduction, external rotation in flexion, internal rotation in extension, and external rotation in extension. Substantial agreement (intra class correlation coefficient, 0.61 to 0.8) was found for adduction, flexion, extension, and internal rotation in flexion. Normative values for hip ROM in children of varying ages have been established with acceptable intraobserver and interobserver reliability. Level II (Diagnostic).

Background The hip's primary function is to dynamically support the weight of the trunk while allowing the force and load transmission axial skeleton to the lower extremity and henceforth allowing mobility. The function of the hip is not only to take the load of the trunk to the lower extremity but also to perform daily activities which include walking, running, jumping, sitting, etc. Hip muscle strength is required to stabilize the pelvic and trunk during squatting and walking (single stance) and to perform other daily living activities. The prevalence rate reports that males are more physically active than females. The number of physical activities has shown to be decreased in teens and young adults between the ages of 14 and 22 years due to transitions in their lifestyle. These changes can be behavioral and due to body composition. The objectives of the study are to determine the influence of hip mobility and strength on the spatial and temporal parameters of gait. Methodology This is a cross-sectional study involving a total of 50 young female populations that have been selected based on the inclusion criteria. Hip range of motion using a universal goniometer was measured in three trials with 30 seconds of rest between each measurement. The hip muscle strength was measured using a handheld dynamometer with 5 seconds hold and three trials taking 30 seconds of rest between each measurement. Spatial parameters of gait were measured by using Kinovea software V.0.8.15, and temporal parameters of gait were measured by asking the subject to walk comfortably in their own speed for 1 minute and the video was taken and measured. Result The hip internal rotation and external rotation has shown to have a statistical significance with spatial and temporal parameters of gait. The hip abductors, adductors, internal rotators, and external rotator muscle strength have shown to have statistical significance with spatial and temporal parameters of gait. Descriptive statistics were used for demographic characteristics, and Pearson's correlation coefficient is used for determining association between outcome variables. Conclusion The hip abductors, adductors, internal rotators, and external rotators have shown to have influence on gait parameters specially with walking speed. The hip internal and external rotation has shown to have influence on gait parameters.

BackgroundPreseason assessment is common in sports teams and aims to analyze athletes’ physical and functional parameters. These data assist physical therapists to develop global and individualized injury prevention programs and...

Study Design Cross-sectional. Background Hip pain is associated with reduced muscle strength and range of movement (ROM). These impairments may contribute to decreased postural stability and balance. The Star Excursion Balance Test (SEBT) is a reliable and valid method to measure dynamic postural control. Objectives To evaluate the association between SEBT performance and hip strength, hip ROM, trunk endurance, and group characteristics in individuals with hip pain. Methods One hundred eleven individuals with hip pain, scheduled for arthroscopic hip surgery, were matched with 62 healthy controls. Hip ROM and muscle strength, trunk endurance, and SEBT reach were measured prior to surgery. Data were analyzed for between-group differences using t tests, and associations between SEBT reach and hip strength, hip ROM, and population characteristics were evaluated with Pearson correlation coefficients and stepwise backward regression analyses. Results Star Excursion Balance Test performance (P<.01), hip strength (P<.01), and hip ROM (P<.05) were lower in the presurgery group compared to controls. In the presurgery group, when adjusted for height and weight, hip flexion strength and internal rotation ROM accounted for 44% of the variance in anteromedial SEBT reach. In the posteromedial direction, hip adduction strength and sex accounted for 53% of the variance. For the posterolateral direction, hip adduction and internal rotation strength accounted for 46% of reach variance. Conclusion The individuals who were scheduled for arthroscopic hip surgery were significantly weaker, had less hip mobility, and had reduced dynamic balance compared to controls. In this population, dynamic balance performance was associated with various hip strength and ROM measurements in a direction-specific manner. J Orthop Sports Phys Ther 2018;48(4):280-288. doi:10.2519/jospt.2018.7946.

The analgesic effect of perioperative low doses of intravenous lidocaine has been demonstrated after abdominal surgery. This study aimed to evaluate whether a continuous intravenous low-dose lidocaine infusion reduced postoperative pain and modified nociceptive pain threshold after total hip arthroplasty. Sixty patients participated in this randomized double-blinded study. Patients received lidocaine 1% (lidocaine group) with a 1.5 mg/kg intravenous bolus in 10 min followed by a 1.5 mg . kg . h intravenous infusion or saline (control group). These regimens were started 30 min before surgical incision and stopped 1h after skin closure. Lidocaine blood concentrations were measured at the end of administration. In both groups, postoperative analgesia was provided exclusively by patient-controlled intravenous morphine. Pain scores, morphine consumption, and operative hip flexion were recorded over 48 h. In addition, pressure pain thresholds and the extent of hyperalgesia around surgical incision were systematically measured at 24 and 48 h. In comparison with the placebo, lidocaine did not induce any opioid-sparing effect during the first 24 h (median [25-75% interquartile range]; 17 mg [9-28] vs. 15 mg [8-23]; P = 0.54). There was no significant difference regarding the effects of lidocaine and placebo on pain score, pressure pain thresholds, extent in the area of hyperalgesia, and maximal degree of active hip flexion tolerated. Mean plasma lidocaine concentration was 2.1 +/- 0.4 mug/ml. Low dose perioperative intravenous lidocaine after total hip arthroplasty offers no beneficial effect on postoperative analgesia and does not modify pressure and tactile pain thresholds.

ObjectiveThe objective of this study was to investigate whether poor hip range of motion (ROM) and strength predict 12‐month physical function decline among older adults with chronic low back pain (LBP) and whether hip osteoarthritis modifies those relationships.MethodsAt baseline, passive ROM and strength measurements were taken for hip flexion, extension, abduction, adduction, internal rotation, and external rotation; ultrasound images and self‐reported symptoms were used to evaluate hip osteoarthritis presence (eg, osteophytes and hip pain). At baseline and 12 months, performance‐based (repeated chair rise, self‐selected gait speed, 6‐minute walk test [6MWT]) and self‐reported (Quebec LBP Disability Questionnaire, Late‐Life Function & Disability Instrument [LLFDI] basic and advanced lower extremity scales) physical function outcomes were assessed. Regression models were constructed for each outcome predicted by baseline hip ROM and strength measures, with adjustment for potential covariates. To avoid collinearity, hip ROM and strength measures with the strongest unadjusted correlations were included in final models. The hip osteoarthritis presence by hip ROM/strength interaction was also explored.ResultsHip abduction strength predicted repeated chair rise (β = −0.297, P < 0.001), gait speed (β = 0.160, P = 0.003), 6MWT (β = 0.159, P ≤ 0.001), Quebec LBP Disability Questionnaire (β = −0.152, P = 0.003), and LLFDI basic lower extremity scale (β = 0.171, P = 0.005) outcomes. Regarding hip ROM, extension predicted repeated chair rise (β = −0.110, P = 0.043) and LLFDI advanced lower extremity scale (β = 0.090, P = 0.007) outcomes, external rotation predicted gait speed (β = 0.122, P = 0.004) outcomes, and abduction predicted LLFDI basic lower extremity scale (β = 0.114, P = 0.026) outcomes. The hip osteoarthritis interaction was not significant for any model.ConclusionReduced hip strength and ROM predict physical function decline; hip osteoarthritis presence may not modify these relationships.