Hip-Abduction Torque and Muscle Activation in People With Low Back Pain

Sutherlin, Mark A.; Hart, Joseph M.

doi:10.1123/jsr.2013-0112

Cited by 16 publications

(18 citation statements)

References 43 publications

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“…The 24 articles [3–6, 16–18, 23–39] investigating gluteus medius function included 1088 participants with LBP and 998 healthy controls without LBP (Table 1). Studies included one or more of the following gluteus medius measurement outcomes: electromyographic (EMG) activity level [17, 18, 26, 28, 29, 31, 34, 38], EMG fatigability [24, 31, 34], EMG time to onset [6, 26, 29, 30], EMG time of peak activation [6, 17, 18, 24, 26, 28–31, 34, 38], hip abductor strength [3–5, 16, 25, 29], Trendelenburg sign [5, 16] hip abductor torque [23, 33], trigger points [16, 27, 35, 36], cross sectional area [32, 37], or muscle thickness [39]. Studies conducted these measurements non-weight bearing [3, 4, 6, 25, 27, 30, 32–37, 39], dynamically weight bearing [17, 23, 26, 38] or statically weight bearing [24, 28, 31].…”

Section: Resultsmentioning

confidence: 99%

“…Two maximal resisted voluntary contractions for a 3s max voluntary contraction with 1 min rest in-between.Right LBP: 1.04 (N/Kg) (± 0.32)Right NLBP: 1.36 (N/Kg) (±0.33)Left LBP: 1.05 (N/Kg) (± 0.26)Left nLBP: 1.23 (N/Kg) (±0.30) p = .04 (right) p = .002 (left)LBP participants had statistically significantly less gluteus medius muscle strength on both sides compared to those without LBP.Nourbakh-sh et al 2002 [3]Pressure meterSide lying hip abduction test. Three maximal voluntary isometric contractions, held for 5 sLBP: 26 kPa (±8)nLBP: 32 kPa (±7), p < .01LBP participants had statistically significantly less gluteus medius muscle strength compared to those without LBP.Sutherlin et al 2015a [33]Isokinetic dynamometerSide lying hip abduction, three maximal voluntary isometric contraction (torque). Hip-abduction trials lasting 5 s were recorded, with 30 s of rest between trials.LBP: 1.64 (Nm/Kg) (±0.44)nLBP: 1.65 (Nm/Kg) (± 0.28), p = .944No statistically significant differences in gluteus medius strength between those with and without LBP.Cooper et al 2016 [16]Subjective MeasureGluteus medius strength was tested by placing subject in side-lying and having the subject abduct and slightly extend the hip while keeping the pelvis rotated slightly forward.…”

Section: Resultsmentioning

confidence: 99%

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Gluteus medius muscle function in people with and without low back pain: a systematic review

Sadler

Cassidy

Peterson

et al. 2019

BMC Musculoskelet Disord

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IntroductionGlobally, low back pain (LBP) is one of the greatest causes of disability. In people with LBP, dysfunction of muscles such as the gluteus medius have been demonstrated to increase spinal loading and reduce spinal stability. Differences in gluteus medius function have been reported in those with LBP compared to those without, although this has only been reported in individual studies. The aim of this systematic review was to determine if adults with a history, or current LBP, demonstrate differences in measures of gluteus medius function when compared to adults without LBP.MethodsMEDLINE, EMBASE, AMED, PsycINFO, PubMED, Pro Quest Database, CINAHL and SPORTDiscus were searched from inception until December 2018 for published journal articles and conference abstracts. No language restrictions were applied. Only case-control studies with participants 18 years and over were included. Participants could have had any type and duration of LBP. Studies could have assessed gluteus medius function with any quantifiable clinical assessment or measurement tool, with the participant non-weight bearing or weight bearing, and during static or dynamic activity. Quality appraisal and data extraction were independently performed by two authors.ResultsThe 24 included articles involved 1088 participants with LBP and 998 without LBP. The gluteus medius muscle in participants with LBP tended to demonstrate reduced strength and more trigger points compared to the gluteus medius muscle of those without LBP. The level of activity, fatigability, time to activate, time to peak activation, cross sectional area, and muscle thickness showed unclear results. Meta-analysis was not performed due to the heterogeneity of included studies.ConclusionClinically, the findings from this systematic review should be considered when assessing and managing patients with LBP. Future studies that clearly define the type and duration of LBP, and prospectively assess gluteus medius muscle function in those with and without LBP are needed.Trial registrationPROSPERO (CRD42017076773).

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Gluteus medius muscle function in people with and without low back pain: a systematic review

Sadler

Cassidy

Peterson

et al. 2019

BMC Musculoskelet Disord

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show abstract

“…However, they used an isokinetic dynamometer using a short lever make test to do these assessments, so this may not be representative of the handheld dynamometry done in the present study. 141 These values are very different from the data observed in this study. To the best of my knowledge, dynamometry assessments of hip extension in a short lever knee flexed position have not been reported in the literature.…”

Section: Sample Representativenesscontrasting

confidence: 94%

“…Sutherlin and Hart reported hip abduction torques for people with and without low back pain. 141 They did not find a difference in hip abduction torque between groups. 141 Based on their reporting we would expect a mean torque of 120 Nm.…”

Section: Sample Representativenessmentioning

confidence: 88%

“…141 They did not find a difference in hip abduction torque between groups. 141 Based on their reporting we would expect a mean torque of 120 Nm. However, they used an isokinetic dynamometer using a short lever make test to do these assessments, so this may not be representative of the handheld dynamometry done in the present study.…”

Section: Sample Representativenessmentioning

confidence: 88%

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Gluteus medius dysfunction in chronic low back pain

Cooper

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Low back pain is a common problem and chronic low back pain is a severe burden. Current thinking in physical therapy tries subgroups people with low back pain based on their symptoms in order to better treat their pain. The role of the gluteus medius muscle is unknown in chronic low back pain. We believe gluteus medius weakness is common and that using exercises to specifically make gluteus medius stronger will be a better treatment than a standard exercise program. In 150 people with chronic low back pain and 75 without any low back pain gluteus medius weakness was more common in those with chronic low back pain. In a group of 56 people with chronic low back pain with gluteus medius weakness, an exercise program focused on gluteus medius strengthening was effective in reducing pain. However it was no more effective than the standard exercise program. People who did more exercise, regardless of group, had less pain and felt that their chronic low back pain was more improved than people who did less exercise. For people with chronic low back pain, performing an exercise program is likely more important than which exercises they do. vi TABLE OF CONTENTS LIST OF TABLES .

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Examination procedures and interventions for the hip in the management of low back pain: a survey of physical therapists

Burns

Cleland

Rivett

et al. 2019

Brazilian Journal of Physical Therapy

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The main research aims were to investigate whether physical therapists are examining the hip(s) in individuals with a primary complaint of low back pain (LBP) and if so, the interventions being provided that target the hip(s). Methods: An anonymous electronic survey was distributed to the membership of the American Physical Therapy Association Orthopaedic and Sports Sections, as well as that of the American Academy of Orthopaedic Manual Physical Therapists. Participant demographics and survey responses were analyzed using descriptive statistics. Associations between variables were examined using chi-square analysis. Results: The estimated response rate was 18.4% (n = 1163, mean age 40.5 ± 11.4 years). The majority of respondents (91%, n = 1059) reported they always or most of the time examined the hip(s) in individuals with LBP. The most common examination items utilized were hip strength testing (94%, n = 948), passive range of motion (91%, n = 921) and muscle flexibility testing (90%, n = 906). The most common interventions included hip strengthening (94%, n = 866) and hip flexibility exercises (90%, n = 814). Respondents enrolled in or having completed a post-professional fellowship were more likely to utilize hip joint manual therapy techniques (x 2 = 25.3, p = <0.001) and less likely to prescribe hip flexibility exercises (x 2 = 7.9, p = 0.005) or use electrophysical modalities (x 2 = 4.3, p = 0.039).

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Hip-Abduction Torque and Muscle Activation in People With Low Back Pain

Cited by 16 publications

References 43 publications

Gluteus medius muscle function in people with and without low back pain: a systematic review

Gluteus medius muscle function in people with and without low back pain: a systematic review

Gluteus medius dysfunction in chronic low back pain

Examination procedures and interventions for the hip in the management of low back pain: a survey of physical therapists

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