A versão femoral está associada a alterações na força dos músculos do quadril em mulheres com impacto femoroacetabular sintomático?

Marostica, Adriano David; Pizzolatti, André Luiz Almeida; Adam, G.; Codonho, Daniel; Canella, Richard Prazeres; Ganev, Gerson Gandhi

doi:10.1055/s-0039-1694019

“…In patients with increased AVA but normal foot progression angle, Passmore et al [25] showed that higher gluteus medius muscle forces are needed for walking with the patient-specific femoral geometry compared to a normal, typical geometry. Several other studies [61][62][63][64] investigated the relationship between femoral geometry and muscle strength. To the best of our knowledge, no studies showed a clear relationship between the femoral geometry (combined AVA and NSA), muscle strength and gait pattern.…”

Section: Plos Onementioning

confidence: 99%

Influence of femoral anteversion angle and neck-shaft angle on muscle forces and joint loading during walking

Kainz,

Mindler,

Kranzl

2023

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Femoral deformities, e.g. increased or decreased femoral anteversion (AVA) and neck-shaft angle (NSA), can lead to pathological gait patterns, altered joint loads, and degenerative joint diseases. The mechanism how femoral geometry influences muscle forces and joint load during walking is still not fully understood. The objective of our study was to investigate the influence of femoral AVA and NSA on muscle forces and joint loads during walking. We conducted a comprehensive musculoskeletal modelling study based on three-dimensional motion capture data of a healthy person with a typical gait pattern. We created 25 musculoskeletal models with a variety of NSA (93°-153°) and AVA (-12°-48°). For each model we calculated moment arms, muscle forces, muscle moments, co-contraction indices and joint loads using OpenSim. Multiple regression analyses were used to predict muscle activations, muscle moments, co-contraction indices, and joint contact forces based on the femoral geometry. We found a significant increase in co-contraction of hip and knee joint spanning muscles in models with increasing AVA and NSA, which led to a substantial increase in hip and knee joint contact forces. Decreased AVA and NSA had a minor impact on muscle and joint contact forces. Large AVA lead to increases in both knee and hip contact forces. Large NSA (153°) combined with large AVA (48°) led to increases in hip joint contact forces by five times body weight. Low NSA (108° and 93°) combined with large AVA (48°) led to two-fold increases in the second peak of the knee contact forces. Increased joint contact forces in models with increased AVA and NSA were linked to changes in hip muscle moment arms and compensatory increases in hip and knee muscle forces. Knowing the influence of femoral geometry on muscle forces and joint loads can help clinicians to improve treatment strategies in patients with femoral deformities.

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“…No previous studies have assessed the relationship between the GTA index and the femoral anteversion angle during clam exercise. In the mid-position of the hip, if the femoral anteversion angle is excessive, the position of the greater trochanter is displaced posteriorly compared to that of the normal anteversion angle [ 62 , 63 ]. When the femoral anteversion angle is increased, the arm length in hip extension and abduction is reduced [ 63 , 64 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of differences in femoral anteversion and hip flexion angle on hip abductor muscles activity during clam exercise in females

Mitomo,

Aizawa,

Hirohata

et al. 2024

PLoS ONE

0

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This study aimed to determine differences in the hip abductor muscle activity during clam exercise at different hip flexion and femoral anteversion angles. Thirty healthy females were divided into two groups based on the femoral anteversion angle: the excessive femoral anteversion group and the normal group. Clam exercise was performed at three different hip flexion angles (60°, 45°, and 30°). Tensor fascia latae, gluteus medius, and superior portion of gluteus maximus activities were measured during the exercise, and the results were normalized to the activity during maximum voluntary isometric contraction to calculate the gluteal-to-tensor fascia latae muscle activation index. The superior portion of gluteus maximus activities at a hip flexion of 60° and 45° were greater than that at 30°. The excessive femoral anteversion group had a lower gluteal-to-tensor fascia latae muscle activation index than the normal group; the gluteal-to-tensor fascia latae muscle activation index for hip flexion at 60° was higher than that at 45°, and the gluteal-to-tensor fascia latae muscle activation index for hip flexion at 60° and 45° were higher than that at 30°. Therefore, the femoral anteversion angle and hip joint position were related to the activity of the hip abductor muscles during clam exercise. These findings may provide a rationale for instructing exercises to maximize the activity of the hip abductor muscles in individuals with an excessive femoral anteversion angle.

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“…In patient with increased AVA but normal foot progression angle, Passmore et al [29] showed that higher gluteus medius muscle forces are needed for walking with the patient-speci c femoral geometry compared to a normal, typical geometry. Several other studies [70][71][72][73] investigated the relationship between femoral geometry and muscle strength. To the best of our knowledge, no studies showed a clear relationship between the femoral geometry (combined AVA and NSA), muscle strength and gait pattern.…”

Section: Discussionmentioning

confidence: 99%

Influence of femoral anteversion angle and neck-shaft angle on muscle forces and joint loading during walking

Kainz

¹

,

Mindler

²

,

Kranzl

³

2023

Preprint

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Femoral deformities, e.g. increased or decreased femoral anteversion (AVA) and neck-shaft angle (NSA), can lead to pathological gait patterns, altered joint loads, and degenerative joint diseases. The mechanism how femoral geometry influences muscle forces and joint load during walking is still not fully understood. Hence, we conducted a comprehensive musculoskeletal modelling study to investigate the influence of femoral AVA and NSA on muscle forces and joint loads during walking. We created 25 musculoskeletal models with a variety of NSA and AVA. For each model we calculated moment arms, muscle forces, muscle moments, and joint loads based on motion capture data of a healthy person with a typical gait pattern. We found a significant increase in co-contraction of hip and knee joint spanning muscles in models with increasing AVA and NSA, which led to a substantial increase in hip and knee joint contact forces. Decreased AVA and NSA had a minor impact on muscle and joint contact forces. Neglecting an individual’s femoral geometry when estimating joint contact forces can lead to errors above five times body weight. Knowing the influence of femoral geometry on muscle forces and joint loads can help clinicians to improve treatment strategies in patients with femoral deformities.

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A versão femoral está associada a alterações na força dos músculos do quadril em mulheres com impacto femoroacetabular sintomático?

Cited by 5 publications

References 26 publications

Influence of femoral anteversion angle and neck-shaft angle on muscle forces and joint loading during walking

Influence of femoral anteversion angle and neck-shaft angle on muscle forces and joint loading during walking

Effects of differences in femoral anteversion and hip flexion angle on hip abductor muscles activity during clam exercise in females

Influence of femoral anteversion angle and neck-shaft angle on muscle forces and joint loading during walking

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