Systematic Review of the Importance of Hip Muscle Strength, Activation, and Structure in Balance and Mobility Tasks

Lanza, Marcel Bahia; Arbuco, Breanna; Ryan, Alice S.; Shipper, Andrea Goldstein; Gray, Vicki L.; Addison, Odessa

doi:10.1016/j.apmr.2021.12.008

Cited by 12 publications

(9 citation statements)

References 71 publications

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“…Conversely, the positive correlation between hip JRS in abduction and functional balance, with a similar coefficient and significance level, underscores the positive role of abduction proprioception in maintaining balance [61]. This finding may reflect the importance of abduction movements in lateral weight shifting, which is essential for balance during gait and other functional activities [49,62]. These findings are consistent with a breadth of previous research.…”

Section: Plos Onesupporting

confidence: 87%

“…The hip muscles are particularly important for performing functional movements efficiently, such as those required in the BBS test, explaining the negative correlation observed between muscle strength and TUG scores [48]. The mild to moderate positive correlations between hip muscle strength (flexors, extensors, and abductors) and the BBS scores corroborate with previous findings suggesting that muscle strength is a key determinant of balance [48][49][50]. These studies have consistently shown that hip muscles play a pivotal role in stabilizing the pelvis and maintaining postural control, which are critical for balance [50].…”

Section: Plos Onesupporting

confidence: 83%

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Balancing act: Unraveling the link between muscle strength, proprioception, and stability in unilateral hip osteoarthritis

Alkhamis,

Reddy,

Alahmari

et al. 2024

PLoS ONE

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The objectives of this study are to compare hip muscle strength, hip joint proprioception, and functional balance between individuals with unilateral hip OA and asymptomatic individuals and to examine the relationships among these variables in the hip OA population. In a prospective cross-sectional study, 122 participants (unilateral Hip OA: n = 56, asymptomatic: n = 56) were assessed at the CAMS/KKU musculoskeletal Physical Therapy laboratory. Ethical standards were upheld throughout the research, with informed consent obtained. Hip muscle strength was measured using a hand-held dynamometer, hip joint proprioception with a digital inclinometer, and functional balance using the Berg Balance Scale (BBS) and Timed Up and Go (TUG) test. Hip OA individuals exhibited significantly lower muscle strength and proprioceptive accuracy, and poorer functional balance than controls (p < 0.003). Correlation analyses revealed a positive correlation between muscle strength and BBS scores (r = 0.38 to 0.42) and a negative correlation with TUG test times (r = -0.36 to -0.41). Hip joint reposition sense (JRS) in flexion showed a negative correlation with balance (r = -0.46), while JRS in abduction was positively correlated (r = 0.46). The study highlights the clinical importance of muscle strength and proprioception in functional balance among individuals with unilateral hip OA. The results support the incorporation of muscle strengthening and proprioceptive training in interventions to improve balance and mobility in this population.

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Section: Plos Onesupporting

confidence: 87%

Section: Plos Onesupporting

confidence: 83%

Balancing act: Unraveling the link between muscle strength, proprioception, and stability in unilateral hip osteoarthritis

Alkhamis,

Reddy,

Alahmari

et al. 2024

PLoS ONE

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“…The association between hip abductor strength and the occurrence of falls has already been demonstrated in previous studies [ 3 , 21 , 47 ], showing that older adults who experienced previous falls also presented weak hip abduction [ 3 , 47 ]. Other studies also showed that hip abductors are involved in controlling postural sway in older adults [ 48 ], contributing to the maintenance of static and dynamic balance [ 49 ] and being critical for balance and mobility function [ 50 ]. In addition, the hip abductor muscles are particularly important in the stance phase of walking, when these muscles are required to provide lateral support at the hip joint and to generate frontal plane stability of the hip, avoiding contralateral pelvis drop, and thereby maintaining the proper alignment between the trunk and lower extremities [ 21 , 51 – 53 ].…”

Section: Discussionmentioning

confidence: 99%

Influence of lower limb isokinetic muscle strength and power on the occurrence of falls in community-dwelling older adults: A longitudinal study

de Almeida Nagata,

Hamu,

Pelicioni

et al. 2024

PLoS ONE

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Introduction Previous studies have highlighted the association between lower limb muscle strength and falls in older adults. However, a comprehensive understanding of the specific influence of each lower limb muscle group on fall occurrences remains lacking. Objective This study aimed to investigate the impact of knee, ankle, and hip muscle strength and power on falls in older adults, with the goal of identifying which muscle groups are more predictive of fall risk in this population. Methods This longitudinal observational study enrolled 94 community-dwelling older adults. Muscle strength and power of the ankle’s plantiflexors and dorsiflexors, knee flexors and extensors, and hip flexors, extensors, adductors, and abductors were assessed using a Biodex System 4 Pro® isokinetic dynamometer. Fall occurrences were monitored through monthly telephone contact over a year. Results Participants, with a median age of 69 years (range 64–74), included 67% women, and 63.8% reported a sedentary lifestyle. Among them, 45,7% of older adults were classified as fallers. Comparative analyses revealed that non-fallers displayed significantly superior isokinetic muscle strength in the hip abductors and adductors, along with higher muscle power in the hip abductors, hip flexors, and knee flexors compared to fallers. Multivariate logistic regression analysis indicated that a 1 Nm/Kg increase in hip abductor strength reduced the chance of a fall by 86.3%, and a 1 Watt increase in hip flexor power reduced the chance of a fall by 3.6%. Conclusion The findings indicate that hip abductor strength and hip flexor power can be considered protective factors against falls in independent older adults in the community. These findings may contribute to developing effective fall-prevention strategies for this population.

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“…We identified a variety of balance and mobility tests used among studies, which is consistent with a previous report. 18 Nonetheless, not only were the tests used different but the investigated variables (eg, center of mass, step initiation, double support, and others) varied across studies. The differences among studies made it difficult to consolidate the information, but in general, the majority of the studies found that when the hip abductors and/or adductor muscles performed better, it was related to more optimal performance in balance and mobility.…”

Section: Discussionmentioning

confidence: 99%

“…11,12 The lateral transfer of weight, which precedes balance and mobility tasks (eg, stepping, walking, and others), [13][14][15] is partially driven by the hip abductors and adductors muscles as previously identified in older adults. [16][17][18] Thus, the hip muscles help to control the body by stabilizing the center of mass or advancing the movement of the lower limbs during balance and mobility tasks in older adults, and it is uncertain if the same is true for individuals after a stroke.…”

Section: Introductionmentioning

confidence: 99%

The Importance of Hip Abductor and Adductor Muscles in Balance and Mobility Tasks After a Stroke: A Systematic Review

Lanza,

Frakes,

Callaghan

et al. 2023

Journal of Stroke Medicine

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The aim of this systematic review was to identify the association between muscle strength, activation, and structure of the hip abductor-adductor muscles and balance and mobility tasks in individuals post stroke. The present systematic review is comprised of 37 research articles, with 911 individuals that had a stroke. The extracted data included the study population, sample size, sex, stroke side of paresis, time poststroke, and evaluated measurements. We concluded that stronger hip abductors and adductors (both paretic and nonparetic legs) resulted in quicker voluntary step, and faster walking speed and cadence. Also, stronger paretic hip abductors were associated with a faster completion of the timed up and go test, higher ambulation ability, better control of the centre of mass, and quicker stair climbing. Overall, it demonstrated a lateral induced step to the paretic side, increased muscle activation of the gluteus medius of the paretic leg, and increased nonparetic hip abductor muscle activation. The strength and ability to activate the hip abductor and adductor muscles appears to be related to better performance during balance or mobility tasks in individuals with stroke. Therefore, the present systematic review results suggest that improving muscle strength and activation of the hip abductor and adductor muscles might help individuals with stroke to avoid falls.

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Systematic Review of the Importance of Hip Muscle Strength, Activation, and Structure in Balance and Mobility Tasks

Cited by 12 publications

References 71 publications

Balancing act: Unraveling the link between muscle strength, proprioception, and stability in unilateral hip osteoarthritis

Balancing act: Unraveling the link between muscle strength, proprioception, and stability in unilateral hip osteoarthritis

Influence of lower limb isokinetic muscle strength and power on the occurrence of falls in community-dwelling older adults: A longitudinal study

The Importance of Hip Abductor and Adductor Muscles in Balance and Mobility Tasks After a Stroke: A Systematic Review

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