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• W2996461758 abstract "Hip-related pain is common in young active people and is associated with intra-articular pathology and the pathogenesis of early onset osteoarthritis (OA). Hip-related pain can impact athletic participation and quality of life, as well as pose an ongoing financial burden to society through costs associated with long term management, including surgery. Improved knowledge of factors that contribute to the symptoms of hip-related pain and progression of joint degeneration are important. Muscles surrounding the hip are proposed to influence joint forces and dynamic stability, which can impact joint health and symptoms, yet little is known about muscle activity or morphology in hip-related pain. A greater understanding of the role that muscles play in hip-related pain may identify pathways for targeted treatment and primary prevention strategies in the future.A systematic review and meta-analysis (Study 1) was undertaken to ascertain the current best evidence regarding muscle morphology in hip-related pain. This review investigated all stages of articular hip pathology across the pathological continuum, identifying the presence of altered muscle morphology in moderate to advanced hip OA. The magnitude of difference in muscle size was not uniform across all muscles, suggesting they may be uniquely influenced by demand in articular pathology. Hypertrophy of deep anterior muscles, spanning the hip joint, in populations with compromised passive stability supports a hypothesis of increased activity to augment joint stability. Limited research has examined muscle activity in earlier stages of hip pathology, highlighting the need for further investigation of muscles surrounding the hip joint to clarify their role in hip-related pain.Iliocapsularis is a pericapsular muscle orientated over the anterior hip with direct attachments to the capsule. Because of its location and capsular insertions, it is theorised to play a dynamic role in joint stability which may be important in hip-related pain. Intramuscular electromyography (EMG) of Iliocapsularis has not been undertaken, due in part to its relative anonymity, and close proximity to the femoral neurovascular bundle posing technical challenges on electrode insertion. A safe and repeatable insertion procedure was required to measure iliocapsularis muscle activity during maximal voluntary isometric contractions (Study 2). A novel technique to place an intramuscular electrode within iliocapsularis was developed and tested in fourteen participants with no adverse effects. Peak Iliocapsularis activity was noted at 90° hip flexion highlighting a potential action on the anterior capsule in this position, but its role in dynamic tasks requires further clarification.  Iliocapsularis and other anterior pericapsular muscles’ activity during dynamic tasks needed to be established (Study 3). By evaluating EMG recordings of iliocapsularis, iliacus, rectus femoris and gluteus minimus in fourteen healthy participants during natural walking and with shortened strides, the impact of a walking pattern commonly associated with hip joint pain and pathology (shortened strides) was able to be tested. The differences in anterior pericapsular EMG seen in shortened strides in healthy participants identified the potential for altered muscle activity to also exist in hip-related pain.To determine whether differences in anterior pericapsular EMG seen at 90° of hip flexion and during shortened strides were also present in hip pathology, muscle activity during these tasks was compared between people with and without hip-related pain (Study 4). When hip flexion was assisted in hip-related pain, to reduce the demand for torque generation, iliocapsularis muscle activity remained consistent with that seen at 90° of active hip flexion. This finding supports the hypothesis of iliocapsularis acting directly on the hip capsule when approaching positions of impingement. Contrary to expectations, greater stride lengths were observed in participants with hip-related pain during walking. This was expected to increase anterior hip-joint forces, yet there was no difference in pericapsular muscle activity, suggesting no additional requirement of muscle activity to control anteriorly directed hip forces during walking at this stage of pathology.In people with hip-related pain, hip-spanning muscles involved in torque production, are thought to influence forces across the hip joint during walking. Young active football players with hip-related pain were compared with football playing controls, to ascertain whether muscle activity differed in the presence of pain (Study 5). Altered rectus femoris muscle activity was observed in hip-related pain participants during walking compared to controls. When participants with hip-related pain were dichotomised based on symptom severity, those with worse symptoms displayed gluteus maximus muscle activity consistent with patterns previously identified in advance OA. Impairments in muscle activity may therefore exist at different points in the pathological spectrum.Due to the cross-sectional nature of the study design, further longitudinal research and investigations involving tasks with higher loads, provocative positions and more advanced articular pathology will help contextualise the findings of the thesis and potentially inform future interventions. Whether modification of hip muscle activity in hip-related pain will benefit symptoms and impact on disease progression is not known, but continued understanding of the impairments associated with this clinical population is essential to guide future research in this area." @default.
• W2996461758 created "2019-12-26" @default.
• W2996461758 creator A5080776618 @default.
• W2996461758 date "2019-11-29" @default.
• W2996461758 modified "2023-10-11" @default.
• W2996461758 title "Muscle activity and morphology in hip-related pain" @default.
• W2996461758 doi "https://doi.org/10.14264/uql.2019.887" @default.
• W2996461758 hasPublicationYear "2019" @default.
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