Correlation between preoperative CT scan of the paraspinal, psoas, and gluteus muscles and postoperative ambulatory status in patients with femoral neck fractures.

BACKGROUND: This study aimed to investigate the relationship between femoral neck fractures and sarcopenia. METHODS: This was a retrospective analysis of 92 patients with femoral neck fractures, from September 2017 to March 2020, who were classified into high ambulatory status (HG) and low ambulatory status (LG) groups. Ambulatory status was assessed before surgery, one week after surgery, at discharge, and during the final follow-up. To evaluate sarcopenia, muscle mass and fatty degeneration of the muscles were measured using preoperative CT. An axial slice of the superior end of the L5 vertebra was used to evaluate the paraspinal and psoas muscles, a slice of the superior end of the femoral head for the gluteus maximus muscle, and a slice of the inferior end of the sacroiliac joint for the gluteus medius muscle. The degeneration of the muscles was evaluated according to the Goutallier classification. RESULTS: The cross-sectional area of the gluteus medius and paraspinal muscles was significantly correlated with ambulatory status before the injury, at discharge, and during the final follow-up. CONCLUSIONS: Measurement of the gluteus medius and paraspinal muscles has the potential to evaluate sarcopenia and predict ambulatory status after femoral neck fractures.

Decoding Hip Muscle Activation: A Comparative Electromyographic Analysis of Turn-Out Bent Knee Pulse and Single-Leg Banded Glute Bridge Exercises in Healthy Female Subjects.

Individuals with lower extremity injuries and back pain may exhibit weakness and stiffness in important muscles such as the gluteus maximus and external hip rotators. To aid clinicians in understanding the impact of exercises on factors like stability, endurance, and strength, electromyography (EMG) examination can be employed to monitor muscle activation. In this investigation, the EMG activity of the gluteus maximus and medius were compared between two exercises: the turn-out bent knee pulse and the single-leg banded glute bridge. The study enrolled a group of 64 healthy young women, aged 19 to 24 years. The raw data collected were standardized and represented as a percentage of maximum voluntary isometric contraction (%MVIC). To assess the reliability of the EMG recordings, the test-retest analysis was performed using the intraclass correlation coefficient (ICC3,1). Statistical analysis involved conducting a one-way ANOVA to compare the EMG amplitudes between the two exercises. Remarkably, the results demonstrated a significantly higher EMG signal amplitude during the single-leg banded glute bridge exercise (mean ± SD: 90 ± 28% MVIC) when compared to the turn-out bent knee pulse exercise (mean ± SD: 70 ± 15% MVIC) (F = 16.584, p = 0.001). The study found that the single-leg banded glute bridge exercise had a significantly higher EMG signal amplitude compared to the turn-out bent knee pulse exercise. This suggests that the single-leg banded glute bridge exercise may be more effective in strengthening the gluteus maximus and medius muscles. Overall, this study highlights the importance of targeted muscle training in rehabilitation protocols and the use of EMG examination to monitor muscle activation.

Association of Piriformis Thickness, Hip Muscle Strength, and Low Back Pain Patients with and without Piriformis Syndrome in Malaysia.

Low back pain is a serious threat to human health and the illness jeopardizes the human workforce and pressurizes the health system in the community. Low back pain might be related to piriformis syndrome (PS), which is a disorder presented as muscular spasm and hypertrophy that is strongly associated with piriformis thickness. Nevertheless, the relationship between piriformis thickness and morphological and functional changes of the gluteal muscles in PS remains unclear. This study aimed to investigate the association between the thickness, strength, and activation of piriformis and gluteus muscles (maximus and medius) among low back pain (LBP) patients with and without PS. This is a case-control study conducted at HSNZ and UiTM from 2019-2020. A total number of 91 participants (LBP + PS (n = 36), LBP - PS (n = 24), and healthy (n = 31)) were recruited in this study. Negative radiography, specific symptoms, and a positive PS test were applied for PS diagnoses. The thickness, strength, and activation of piriformis and gluteus muscles were measured using ultrasonography (USG) and a surface electromyogram, respectively. Resultantly, the one-way ANOVA test demonstrated no significant difference in piriformis thickness between LBP + PS and LBP - PS (p > 0.01). Piriformis thickness was inversely correlated with gluteus maximus strength (r = -0.4, p < 0.05) and positively correlated with gluteus medius activation (r = 0.48, p < 0.01) in LBP + PS. Stepwise linear regression for LBP + PS revealed a significant association between piriformis thickness and gluteus maximus strength (R = -0.34, accounted for 11% of the variance) and gluteus medius activation in prone lying with the hip in an externally rotated, abducted, and extended (ERABEX) position (R = 0.43, accounted for 23% of the variance). With the adjustment of age and gender, piriformis thickness, gluteus maximus strength, and gluteus medius activation in prone lying with hip ERABEX demonstrated a significant association, but no independent effect of age and gender was detected within the range. Meanwhile, a significant association between piriformis thickness and gluteus maximus thickness was observed (R = 0.44, accounted for 19% of the variance) in the LBP - PS group. These findings may assist to elucidate the actions and functions of piriformis and gluteus muscle in LBP with and without PS.

Muscle Atrophy Measurement as Assessment Method for Low Back Pain Patients.

Low back pain is one of the most common pain disorders defined as pain, muscle tension, or stiffness localized below the costal margin and above the inferior gluteal folds, sometimes with accompanying leg pain. The meaning of the symptomatic atrophy of paraspinal muscles and some pelvic muscles has been proved. Nowadays, a need for new diagnostic tools for specific examination of low back pain patients is posited, and it has been proposed that magnetic resonance imaging assessment toward muscle atrophy may provide some additional information enabling the subclassification of that group of patients.

Development and validation of a VISA tendinopathy questionnaire for greater trochanteric pain syndrome, the VISA-G.

BACKGROUND: Greater trochanteric pain syndrome (GTPS) is common, resulting in significant pain and disability. There is no condition specific outcome score to evaluate the degree of severity of disability associated with GTPS in patients with this condition. OBJECTIVE: To develop a reliable and valid outcome measurement capable of evaluating the severity of disability associated with GTPS. METHODS: A phenomenological framework using in-depth semi structured interviews of patients and medical experts, and focus groups of physiotherapists was used in the item generation. Item and format clarification was undertaken via piloting. Multivariate analysis provided the basis for item reduction. The resultant VISA-G was tested for reliability with the inter class co-efficient (ICC), internal consistency (Cronbach's Alpha), and construct validity (correlation co-efficient) on 52 naïve participants with GTPS and 31 asymptomatic participants. RESULTS: The resultant outcome measurement tool is consistent in style with existing tendinopathy outcome measurement tools, namely the suite of VISA scores. The VISA-G was found to be have a test-retest reliability of ICC2,1 (95% CI) of 0.827 (0.638-0.923). Internal consistency was high with a Cronbach's Alpha of 0.809. Construct validity was demonstrated: the VISA-G measures different constructs than tools previously used in assessing GTPS, the Harris Hip Score and the Oswestry Disability Index (Spearman Rho:0.020 and 0.0205 respectively). The VISA-G did not demonstrate any floor or ceiling effect in symptomatic participants. CONCLUSION: The VISA-G is a reliable and valid score for measuring the severity of disability associated GTPS.