Females with hip pain walk with altered kinematics at peaks and throughout the gait cycle.

BACKGROUND: Females with acetabular dysplasia and/or labral tears (hip pain) exhibit altered walking kinematics, with studies reporting mixed results in sagittal and frontal planes compared to pain-free controls, often conducting only discrete analyses and warranting further investigation. The objective of this study was to investigate discrete and continuous hip and pelvic kinematics between females with and without hip pain in two walking conditions. METHODS: We collected kinematic walking data from 69 females (35 with hip pain, 34 controls) using motion capture and an instrumented treadmill in two conditions: preferred and fast (125% preferred). We used a general linear model and one-dimensional statistical parametric mapping to conduct discrete and continuous analyses comparing kinematics between groups, with and without adjustment for gait speed. FINDINGS: The hip pain group walked with reduced peak hip extension (Preferred: P = .046, Cohen's d = 0.41; Fast: P = .028, d = 0.48) and greater peak anterior pelvic tilt (Preferred: P = .011, d = 0.57; Fast: P = .012, d = 0.58) compared to controls. From continuous analyses, the hip pain group walked with reduced hip extension during terminal stance (Fast: P = .040), greater anterior pelvic tilt throughout (Preferred: P = .007; Fast: P = .004), and greater contralateral pelvic drop (Preferred: P = .045) during midstance. Adjusting for speed slightly affected p-values, but significance was retained for all prior variables except pelvic drop. INTERPRETATION: Kinematic differences between individuals with and without hip pain may provide insight into potential predisposing factors for hip pathology and/or compensations for pain or pathological processes. This work furthers understanding of altered movement patterns in individuals with hip pain and may inform physical therapy treatments.

Physical Therapists' Prognosis of Outcomes After a Hip or Quadriceps Exercise Intervention in Patients With Patellofemoral Pain: A Secondary Analysis of a Randomized Trial.

OBJECTIVE: Can physical therapists who are treating patients with patellofemoral pain (PFP) predict the outcome of a 12-week exercise intervention based on initial assessment, and what are the physical therapists' reasons for prediction? DESIGN: Secondary analysis of a randomized trial. METHODS: After the initial assessment, physical therapists were asked to predict the prognosis of 200 patients with PFP who were allocated to 12 weeks of quadriceps exercises (QEs) or hip exercises (HEs) on a 1-to-10 Likert scale, and to describe their reasoning for the prediction score. OUTCOMES: measures were changes from baseline to weeks 12 and 26 on the Anterior Knee Pain Scale (range 0-100) and a transition questionnaire (TransQ). Linear mixed-effects models were used to assess the prediction. Secondly, we used a qualitative approach to summarize the physical therapists' reasoning (written notes) when predicting the outcome. RESULTS: There was no association between physical therapists' prognosis and changes in Anterior Knee Pain Scale for QE or HE at weeks 12 and 26 (slopes: -0.14 to -0.51 with wide 95% confidence intervals). There was no association between physical therapists' assessment of prognosis using TransQ for QE or HE at weeks 12 and 26 (odds ratio: 0.99 to 1.17 with wide 95% confidence intervals). CONCLUSION: Physical therapists' prognosis based on initial assessment was not associated with outcomes after 12 weeks of either quadriceps or hip exercise therapy among patients with PFP. Physical therapists' prognoses were not useful as a source of information and to identify PFP patients with poor or good projected outcomes. J Orthop Sports Phys Ther 2024;54(8):541-550. Epub 6 June 2024. doi:10.2519/jospt.2024.12258.

Déficit motor en el puerperio. ¿Es la analgesia neuroaxial la causa más frecuente? / Motor deficit in the puerperium. Is neuroaxial analgesia the most frequent cause?

Los déficits motores de miembros inferiores durante el embarazo y el puerperio son relativamente frecuentes. Se atribuyen habitualmente a complicaciones asociadas a las técnicas neuroaxiales que son realizadas por el anestesiólogo. Pero existen otras posibles causas, como la osteoporosis transitoria de caderas. La osteoporosis transitoria del embarazo es una patología infrecuente y autolimitada de origen desconocido. La complicación más severa que puede presentar son las fracturas patológicas, fundamentalmente en las articulaciones de carga. Esta patología suele presentarse en el tercer trimestre del embarazo y cursa con dolor e impotencia funcional del miembro inferior afecto. Presentamos el caso de una mujer de 35 años, gestante de 40+3 semanas que inicia trabajo de parto. Se coloca catéter epidural normofuncionante y finalmente se decide cesárea por parto estacionado; 48h después comienza con impotencia funcional en miembro inferior izquierdo y dolor. Se realiza RM donde se descarta hematoma epidural y se objetiva osteopenia de caderas, siendo diagnosticada de osteoporosis transitoria el embarazo

Motor deficits of lower limbs during pregnancy and the puerperium are relatively frequent. They are usually attributed to complications which are associated with neuroaxial techniques performed by the anesthesiologist. But there are other possible causes, such as transient osteoporosis of the hips. Transient osteoporosis of pregnancy is a rare and self-limited pathology of unknown etiology. The most severe complication that can occur are pathological fractures, mainly in the load joints. This pathology usually occurs in the third trimester of pregnancy and is showed up with pain and functional impotence of the lower limb affected. We present the case of a 35-year-old woman, 40+3 weeks of pregnancy who starts labour. Normally functioning epidural catheter is placed and finally cesarean section is decided because failure to progress; 48h later the patient begins with functional impotence and pain in the lower left limb. MRI is performed, epidural hematoma is ruled out and osteopenia of the hips is proved. The patient is diagnosed with transient osteoporosis of pregnancy

Conservative management of femoroacetabular impingement (FAI) in professional basketball

Femoroacetabular impingement (FAI) is a common injury in basketball, having a difficult therapeutic approach because it requires an extended period of time to be resolved once it appears. Therefore, preventing the onset of this condition seems critical in maintaining athletes' health, and availability to compete. Because reducing training and competition volume in a professional team context is complex, the exercises presented here offer a good option for managing injured players without compromising their availability during the season. However, offseason and preseason periods are key to developing, protecting and strengthening the injured joint and its functionality for the competitive season

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The use of surface electromyography to assess transfemoral amputees: methodological and functional perspective

Aim: Surface electromyography (sEMG) has been established as a safe non-invasive method to investigate neuromuscular function. However, the use of this instrument to assess lower limbs of transfemoral amputees still presents a lack of standardization in its methods of signal acquisition and processing. The aim of this study was to review the current state of sEMG utilization to assess transfemoral amputees, the procedures adopted for the acquisition and the functional findings. Methods: This is a literature review. Five electronic databases were searched to find the studies: All relevant information of each study was extracted and registered. Methodological quality was evaluated using a customized checklist. Results: Eight studies followed the inclusion criteria and were included in this paper. Four studies did not reach more than 80% of the quality checklist, few studies fully described the methodology applied. The muscles assessed were similar in all studies, electrodes placement was determined by different criteria. Conclusion: This paper demonstrates that a few studies have used this method to assess this population and the main variable aspect is concerned to the placement of the electrodes. More researches are needed to better understand the neuromuscular behavior of amputees by using sEMG and assist future researches to develop more reproducible and reliable studies.(AU)

Programas de bipedestación para la prevención de la displasia de cadera en niños con síndrome de Down / Standing programs to prevent hip dysplasia in children with Down's syndrome

Objetivo: Valorar cómo influye el uso de los programas de bipedestación en la prevención de la displasia de cadera en una cohorte de niños con síndrome de Down. Material y métodos: Se realizó un estudio retrospectivo a lo largo de 11 años a 76 niños con síndrome de Down que asistieron al Centro de Desarrollo Infantil y Atención Temprana de la Asociación para Personas con Síndrome Down de Murcia. El 21% de los niños (16) presentaban inestabilidad de cadera y el 17% (13) de ellos usaron un programa de bipedestación durante 10 meses de media. Resultados: Ninguno de los niños que usaron el programa de bipedestación desarrollaron displasia de cadera. Conclusiones: Los programas de bipedestación pueden ser eficaces en la prevención de la displasia de cadera en niños con trisomía 21

Objective: To assess the influence of the use of standing programs to prevent hip dysplasia in a cohort of children with Down's syndrome. Material and methods: An 11-year retrospective study of 76 children with Down's syndrome attending the Centre for Child Development and Early Intervention of the Associaton for People with Down's Syndrome in Murcia. Unstable hips were found in 21% (16) of children, and 17% (13) of them used a standing program for an average of 10 months. Results: None of the children that used the standing program developed hip dysplasia. Conclusions: Standing programs may be effective in preventing hip dysplasia in children with trisomy 21

Amplitude de movimento e sua interferência na capacidade funcional de pacientes com sequelas de queimaduras / Movement range and its interference with the functional capacity of patients with burns sequels / Amplitud de movimiento y su interferencia na capacidad funcional de pacientes con quemaduras

bjetivo: Avaliar a amplitude de movimento de indivíduos com sequelas de queimadura e a interferência na capacidade funcional. Método: Esta pesquisa foi do tipo transversal, descritiva e de campo, sendo a amostra selecionada por conveniência, consistindo de um estudo piloto. Utilizou-se o flexímetro Sanny para avaliação da amplitude de movimento e a Medida de Independência Funcional para avaliação da capacidade funcional do paciente queimado, seguindo um protocolo de avaliação confeccionado pelas próprias pesquisadoras. Este estudo foi realizado em um Centro de Reabilitação, incluindo-se pacientes com história de queimaduras há mais de seis meses. Resultados: Após a coleta, observou-se predomínio do gênero masculino, com queimaduras de 3º grau, decorrentes de agentes inflamáveis. Quanto à avaliação de amplitude de movimento, verificou-se que o ombro e o joelho foram as articulações mais comprometidas. E quanto às atividades funcionais, as tarefas mais acometidas foram vestir parte superior e arrumar-se. Conclusões: Considerando-se a relevância desta pesquisa e a amostra reduzida por se tratar de um estudo piloto, sugere-se que sejam realizados novos estudos com um quantitativo maior de pacientes, a fim de que possa haver resultados mais consistentes acerca desta abordagem.

Objective: To evaluate the range of motion of individuals with burn sequelae and interference in functional capacity. Method: This was a cross-sectional, descriptive research, with the sample selected by convenience in the field, consisting of a pilot study. We used the Sanny fleximeter to evaluate the range of motion and the Functional Independence Measure for assessing the functional capacity of the burned patient, following an evaluation protocol made by the researchers themselves. This study was conducted at the Health Center, including patients with a history of burns for more than six months. Results: There was a predominance of males, with burns of 3nd degree, due to flammable agents. Limitation observed in several joints, with a predominance of elbow and ankle, reflecting directly on the functional capability shown by these individuals. The functional activities more affected were dress up and pack up. Conclusions: Considering the relevance of this research and the reduced sample because it is a pilot study, it is suggested that further studies be conducted with a larger number of patients, so that there may be more consistent results about this approach.

Objetivo: El objetivo de esta investigación fue evaluar el rango de movimiento de las personas con secuelas de quemaduras y la interferencia en la capacidad funcional. Método: Esta investigación fue transversal, descriptivo y de campo, y la muestra seleccionada por conveniencia, que consiste en un estudio piloto. Se utilizó el flexímetro Sanny para evaluar la amplitud de movimiento y la medida de la independencia funcional para evaluar la capacidad funcional del paciente quemado, siguiendo un protocolo de evaluación realizado por los propios investigadores. Este estudio se realizó en el Centro derehabilitación, incluyendo pacientes con antecedentes de quemaduras durante más de seis meses. Resultados: Después, hubo un predominio del sexo masculino, con quemaduras de 3er grado, que resulta de agentes inflamables. En cuanto a la gama de evaluación de movimiento, se encontró que las articulaciones del hombro y de la rodilla eran los más afectados. ¿Qué pasa con las actividades funcionales, las tareas más afectados fueron el uso de top y aseo personal. Conclusiones: Teniendo en cuenta la relevancia de esta investigación y la muestra reduce porque se trata de un estudio piloto, se sugiere que se realicen más estudios con una mayor cantidad de pacientes, por lo que puede haber resultados más consistentes en este enfoque.

Usefulness of Arthroscopic Treatment of Painful Hip after Acetabular Fracture or Hip Dislocation

BACKGROUND: Painful hip following hip dislocation or acetabular fracture can be an important signal for early degeneration and progression to osteoarthritis due to intraarticular pathology. However, there is limited literature discussing the use of arthroscopy for the treatment of painful hip. The purpose of this retrospective study was to analyze the effectiveness and benefit of arthroscopic treatment for patients with a painful hip after major trauma. METHODS: From July 2003 to February 2013, we reviewed 13 patients who underwent arthroscopic treatment after acetabular fracture or hip dislocation and were followed up for a minimum of 2 postoperative years. The degree of osteoarthritis based on the Tonnis classification pre- and postoperatively at final follow-up was determined. Clinical outcomes were evaluated using visual analogue scale for pain (VAS) and modified Harris hip score (MHHS), and range of motion (ROM) of the hip pre- and postoperatively at final follow-up. RESULTS: There were nine male and four female patients with a mean age at surgery of 28 years (range, 20 to 50 years). The mean follow-up period of the patients was 59.8 months (range, 24 to 115 months), and the mean interval between initial trauma and arthroscopic treatment was 40.8 months (range, 1 to 144 months). At the final follow-up, VAS and MHHS improved significantly from 6.3 and 53.4 to 3.0 and 88.3, respectively (p = 0.002 and p < 0.001, respectively). However, there were no significant differences in hip flexion, abduction, adduction, external rotation, and internal rotation as minor improvements from 113.1°, 38.5°, 28.5°, 36.5°, and 22.7° to 118.5°, 39.0°, 29.2°, 38.9°, and 26.5° were observed, respectively (p = 0.070, p = 0.414, p = 0.317, p = 0.084, and p = 0.136, respectively). None of the patients exhibited progression of osteoarthritis of the hip at the final follow-up. CONCLUSIONS: Arthroscopic treatment after acetabular fracture or hip dislocation is effective and delays the progression of traumatic osteoarthritis.

Thorax, pelvis and hip pattern in the frontal plane during walking in unilateral transtibial amputees: biomechanical analysis

Background: Lower limb amputees exhibit postural control deficits during standing which can affect their walking ability. Objectives: The primary purpose of the present study was to analyze the thorax, pelvis, and hip kinematics and the hip internal moment in the frontal plane during gait in subjects with Unilateral Transtibial Amputation (UTA). Method: The participants included 25 people with UTA and 25 non-amputees as control subjects. Gait analysis was performed using the Vicon(r) Motion System. We analyzed the motion of the thorax, pelvis, and hip (kinematics) as well as the hip internal moment in the frontal plane. Results: The second peak of the hip abductor moment was significantly lower on the prosthetic side than on the sound side (p=.01) and the control side (right: p=.01; left: p=.01). During middle stance, the opposite side of the pelvis was higher on the prosthetic side compared to the control side (right: p=.01: left: p=.01). Conclusions: The joint internal moment at the hip in the frontal plane was lower on the prosthetic side than on the sound side or the control side. Thorax and pelvis kinematics were altered during the stance phase on the prosthetic side, presumably because there are mechanisms which affect postural control during walking. .

Osteopenia y osteoporosis en mujeres con factores de riesgo / Osteopenia and osteoporosis in women with risk factors

Objetivo: determinar la prevalencia de osteopenia y osteoporosis en mujeres con factores de riesgo en la provincia de Jaén, identificar la relación entre los factores de riesgo y el lugar de realización de la prueba con el diagnostico Material y método: estudio descriptivo transversal. Se incluyeron mujeres que acudieron a una consulta privada de ginecología. Se les realizo una densitometría ósea en columna y cadera (técnica Dexa). Se efectuó un análisis univariante tanto para las variables cuantitativas como cualitativas. El contraste de hipótesis se desarrollo mediante el coeficiente de correlación de Pearson en las cualitativas y la Ji-cuadrado en las cualitativas. Resultados: se estudiaron 151 mujeres, con una edad media de 56 años, y un IMC promedio de 26,86. El 57% se realizaron la prueba para la prevención de osteopenia y osteoporosis. Existía relación entre edad, el peso y el IMC (factor protector) y el diagnostico de osteopenia u osteporosis. La prevalencia de osteoporosis fue de un 4% cuando la prueba se efectuó en cadera y de un 20% cuando se hizo en columna. Conclusiones: la edad se posiciona como un factor de riesgo en la aparición de osteopenia y osteoporosis. El peso y el aumento del IMC parecen actuar como factor protector en estas mujeres. Existe una importante diferencia diagnostica entre ambas en función del lugar de realización de la densitometría ósea, siendo mayor la prevalencia cuando se efectuaba en cadera (AU)

Objective: to determine the prevalence of osteopenia and osteoporosis in women with risk factors in the province of Jaen, to identify the relationship between risk factors and the site on which the diagnosis test is conducted. Materials and method: transversal descriptive study. It included women who visited a Gynaecologist in the private setting. They underwent a bone density test of the hip and spine (DEXA technique). Univariate analysis was conducted both for quantitative and qualitative variables. Hypothesis contrast was developed through Pearson Correlation Coefficient in quantitative variables, and Ji-square in qualitative variables. Results: the study was conducted on 151 women, with 56 years as median age, and an average BMI of 26.86. Of these, 57% underwent the test in order to prevent osteopenia and osteoporosis. There was a connection between age, weight and BMI (protective factor) and the diagnosis of osteopenia or osteoporosis. Prevalence of osteoporosis was 4% when the test was conducted on the hip, and 20% when it was conducted on the spine. Conclusions: age is positioned as a risk factor for the presence of osteopenia and osteoporosis. Weight and increase in BMI seem to act as a protective factor in these women. There is an important diagnostic difference between them, based on the area in the body where the bone density test was performed, with a higher prevalence when performed on the hip (AU)

Translation, cross-cultural adaptation and validation of the Brazilian version of the Nonarthritic Hip Score / Traducao, adaptacao cultural e validacao da versao brasileira do questionario Nonarthritic Hip Score

CONTEXT AND OBJECTIVE The Nonarthritic Hip Score (NAHS) is a clinical evaluation questionnaire that was developed in the English language to evaluate hip function in young and physically active patients. The aims of this study were to translate this questionnaire into the Brazilian Portuguese language, to adapt it to Brazilian culture and to validate it. DESIGN AND SETTING Cohort study conducted between 2008 and 2010, at Universidade do Estado do Rio de Janeiro (UERJ). METHODS Questions about physical activities and household chores were modified to better fit Brazilian culture. Reproducibility, internal consistency and validity (correlations with the Algofunctional Lequesne Index and the Western Ontario and McMaster Universities Arthritis Index [WOMAC]) were tested. The NAHS-Brazil, Lequesne and WOMAC questionnaires were applied to 64 young and physically active patients (mean age, 40.9 years; 31 women). RESULTS The intraclass correlation coefficient (which measures reproducibility) was 0.837 (P < 0.001). Bland-Altman plots revealed a mean error in the difference between the two measurements of 0.42. The internal consistency was confirmed through a Cronbach alpha of 0.944. The validity between NAHS-Brazil and Lequesne and between NAHS-Brazil and WOMAC showed high correlations, r = 0.7340 and r = 0.9073, respectively. NAHS-Brazil showed good validity with no floor or ceiling effects. CONCLUSION The NAHS was translated into the Brazilian Portuguese language and was cross-culturally adapted to Brazilian culture. It was shown to be a useful tool in clinical practice for assessing the quality of life of young and physically active patients with hip pain. .

CONTEXTO E OBJETIVO O Nonarthritic Hip Score (NAHS) é um questionário de avaliação clínica que foi desenvolvido na língua inglesa para avaliar a função do quadril em pacientes jovens e fisicamente ativos. O objetivo desse estudo foi traduzir o questionário NAHS para a língua portuguesa do Brasil, adaptá-lo à cultura brasileira e validá-lo. TIPO DE ESTUDO E LOCAL Estudo de coorte, realizado entre 2008 e 2010, na Universidade do Estado do Rio de Janeiro (UERJ). MÉTODOS Questões sobre atividades físicas e tarefas domésticas foram modificadas para melhor adaptação à cultura brasileira. Reprodutibilidade, consistência interna e validade (correlação entre o Algofunctional Lequesne Index e o Western Ontario McMaster Universities Arthritis Index [WOMAC]) foram testadas. Os questionários NAHS-Brasil, Lequesne e WOMAC foram aplicados em 64 pacientes jovens e fisicamente ativos (média de idade, 40,9 anos; 31 mulheres). RESULTADOS O coeficiente de correlação intraclasse que avalia reprodutibilidade mostrou valores de 0,837 (P < 0,001). O gráfico de Bland-Altman revelou um erro médio da diferença das duas medidas de 0,42. A consistência interna foi avaliada pelo alfa de Cronbach com valores de 0,944. A validade entre os questionários NAHS-Brasil/Lequesne e NAHS-Brasil/WOMAC mostraram alta correlação, r = 0,7340 e r = 0,9073; respectivamente. O NAHS-Brasil mostrou boa validade sem efeitos de chão ou de teto. CONCLUSÃO O NAHS foi traduzido para a língua portuguesa do Brasil e adaptado para a cultura brasileira, mostrando ser uma ferramenta útil na prática clínica para avaliar a qualidade de vida de pacientes jovens e fisicamente ativos com dor no quadril. .

Filogenia de la articulación de la cadera. Plasticidad del fenotipo. ¿Paradigma Lamarckiano o Darwiniano? Parte II / Hip Joint phylogenesis. Phenotypic plasticity. Lamarckian or Darwinian paradigm? Part II

Objetivo. El objetivo de este trabajo es analizar el origen de los cambios plásticos del fenotipo en una estructura biológica, en nuestro caso la cadera. Como hipótesis de trabajo se presenta la posibilidad de que los cambios se puedan interpretar según el paradigma Lamarckiano, en contraposición al paradigma Darwiniano. La sección material y método del trabajo se menciona en la parte I. Se han añadido estudios de plantas y peces. Discusión. Los resultados muestran que el diseño de la cadera, como relación de bola y cuenco, no cambia. El fenotipo, en los elementos que costituyen los tejidos de la articulación de la cadera, muestra cambios plásticos significativos. Conclusión. Sugerimos: que los cambios de la plasticidad del fenotipo de la cadera son inmanentes al fenotipo, y no se interpretan según el paradigma Lamarckiano ni Darwiniano (AU)

Objective. The aim of this work is to analyse the origin of phenotypic plastic changes into a biologic structure, in this case the hip. As a hypothesis of the work, the possibility that changes could be explained following the Lamarckian paradigm, opposed to the Darwinian paradigm, is shown. The section material and methods of this work have been published in part I. Studies in plants and fish have been added. Discussion. Results showed that the ball-and-socket design of the hip joint remains unchanged. Phenotype in the elements that form the hip joint tissues showed significant plastic changes. Conclusion. Interpretation of our results suggest that changes in phenotype plasticity of the hip joint are immanent to phenotype and cannot be explained by following Lamarck's or Darwin's paradigm (AU)

Low Handgrip Strength is Associated with Low Bone Mineral Density and Fragility Fractures in Postmenopausal Healthy Korean Women

Osteoporosis is a widely recognized health problem in postmenopausal women. Osteoporotic fractures reduce independency, limit daily living activities, and increase the mortality rate. Epidemiological studies have demonstrated that low handgrip strength is a risk factor for functional limitations and disabilities, and all-cause mortality. We investigated the relationship between handgrip strength and bone mineral density (BMD) of the spine, femur neck, and total hip, as well the relationship between handgrip strength and previous fragility fractures in 337 healthy postmenopausal Korean women (mean age of 59.5 +/- 6.8 yr) who were free of diseases or medications affecting bone metabolism. Age and handgrip strength were associated with BMD of the spine, femur neck, and total hip in multiple regression models. Low handgrip strength (odds ratio [OR], 0.925; range, 0.877 to 0.975; P = 0.004) and low femur neck BMD (OR, 0.019; range, 0.001 to 0.354; P = 0.008) were independent predictors of previous fragility fractures in a multiple regression model. Our results demonstrate that low handgrip strength is associated with low BMD of the spine, femur neck, and total hip, and with increased risk of previous fragility fractures.

Electromyographic activity during active prone hip extension did not discriminate individuals with and without low back pain / Atividade eletromiográfica durante o movimento de extensão do quadril em prono não discrimina indivíduos com dor lombar

BACKGROUND: Changes in activation of the trunk and hip extensor muscles can result in excessive stress on the lumbar spinal structures, predisposing them to lesions and pain. OBJECTIVES: To compare electromyographic activity of the gluteus maximus, semitendinosus and the erector spinae muscles between asymptomatic and individuals with low back pain during active prone hip extension exercises. METHODS: Fifty individuals were recruited and divided into two groups: 30 asymptomatic (24.5±3.47 years) and 20 with mechanical low back pain (28.75±5.52 years). They performed active prone hip extension exercises, while the activation parameters (latency, duration and quantity of activation) of the investigated muscles were recorded by electromyography. The beginnings of the movements were detected by a motion capture system. Differences between the groups were investigated employing Student t-tests or Mann-Whitney-U tests, according to the data distribution. RESULTS: No significant differences were found between the groups for any of the investigated muscles. Muscular activation patterns were similar for both groups, starting with the semitendinosus, followed by the erector spinae, and then, by the gluteus maximus. For both groups, significant delays in the onset of the gluteus maximus were observed. CONCLUSIONS: The assessment of the electromyographic activity was not capable of discriminating individuals with and without low back pain, suggesting an overlap in the studied populations.

CONTEXTUALIZAÇÃO: Alterações no padrão de recrutamento dos extensores de tronco e quadril podem resultar em estresse excessivo sobre estruturas da coluna lombar, predispondo-a à lesão e dor. OBJETIVOS: Comparar a atividade eletromiográfica dos músculos glúteo máximo, semitendíneo e eretores espinhais entre indivíduos assintomáticos e com dor lombar durante o exercício de extensão de quadril em prono. MÉTODOS: Cinquenta indivíduos foram recrutados e divididos em dois grupos: 30 assintomáticos (24,5±3,47 anos) e 20 com dor lombar (28,75±5,52 anos). Os parâmetros de ativação (latência, duração e quantidade de ativação) dos músculos investigados durante os exercícios de extensão de quadril foram registrados por meio da eletromiografia. O início e o término do movimento foram detectados por um sistema de análise de movimento. Diferenças entre os grupos foram investigadas utilizando-se teste t de Student ou Mann-Whitney-U, dependendo da distribuição. RESULTADOS: Não foram observadas diferenças significativas entre os grupos para nenhum dos músculos investigados. O padrão de recrutamento foi similar para os dois grupos, iniciando-se pelo semitendíneo, seguido pelos paravertebrais e finalizado pelo glúteo máximo. Nos dois grupos, observou-se um aumento significativo na latência do glúteo máximo comparado aos demais músculos. CONCLUSÕES: A avaliação do padrão de recrutamento não foi capaz de separar indivíduos com e sem dor lombar, sugerindo ocorrer uma sobreposição entre as populações estudadas.

Osteoporosis transitoria migratoria / Transient migrant osteoporosis

Objetivo: Presentar un caso de osteoporosis transitoria migratoria. Caso clínico: Mujer de 50 años que desarrolla sucesivamente dolor en la cadera izquierda, la rodilla izquierda y el tobillo derecho. La resonancia magnética (RM) de cadera establece el diagnóstico de osteoporosis transitoria de cadera y las sucesivas migraciones establecen el diagnóstico de osteoporosis transitoria migratoria. Resultados: La sintomatología remite con tratamiento conservador, con reposo, analgésicos, antiinflamatorios, descarga y fisioterapia hasta que los síntomas disminuyan. La descarga disminuye el dolor y previene la fractura por fatiga. El tratamiento médico no altera el curso de la enfermedad tras 65 semanas. Conclusión: La osteoporosis transitoria migratoria es rara, idiopática y autolimitada. Cursa con dolor migratorio en las articulaciones de carga, osteopenia radiográfica difusa periarticular y patrón de edema medular óseo en la RM. Su tratamiento es conservador (AU)

Purpose: To report on a case of transient migrant osteoporosis. Clinical case: We present the case of a 50-year-old female who developed pain in the left hip, left knee and right ankle successively. Her hip MRi prompted a diagnosis of transient hip osteoporosis and successive migrations resulted in a diagnosis of transient migrating osteoporosis. Results: Symptoms abated with conservative treatment comprising rest, analgesics, anti-inflammatories, non-weight bearing and physical therapy. Non-weight bearing relieved pain and prevented fatigue fractures. Medical treatment did not alter the course of the disease after 65 weeks. Conclusion: Transient migrating osteoporosis is a rare, idiopathic and self-limiting disease. It is accompanied by migrating pain in the weight-bearing joints, as well as by diffuse periarticular radiographic osteopenia and a pattern of bone marrow edema seen on MRi. Treatment is conservative (AU)

Diferencias en la frecuencia de osteoporosis según la región esquelética evaluada. Análisis de 987 mujeres posmenopáusicas remitidas a una unidad de densitometría / Differences in the frequency of osteoporosis according to the skeletal site evaluated. Analysis in 987 Spanish postmenopausal women referred to a bone densitometry unit

Objetivo: Analizar, en un grupo de mujeres posmenopáusicas, las diferencias en la frecuencia de osteoporosis según la localización anatómica utilizada para realizar el diagnóstico. Métodos: Se recopilaron las características demográficas y los valores de la densidad mineral ósea (DMO) de 987 mujeres posmenopáusicas (media de edad, 53,8±5,5 años). La DMO se evaluó mediante absorciometría fotónica dual de fuente de rayos X (DXA). Se utilizaron las categorías de la OMS para clasificar a las pacientes. Se calcularon los T-score de cada vértebra lumbar de forma individualizada (L2, L3 y L4), del valor medio del análisis de la columna lumbar (L2-L4), del cuello femoral y de la cadera total. Resultados: En 144 (14,7%) mujeres, se observaron discrepancias entre el análisis individualizado de cada vértebra lumbar y el análisis de L2-L4; 62 (6%) mujeres que presentaban osteoporosis en al menos una vértebra se adscribían a la categoría osteopenia al considerar el valor medio del análisis de L2-L4. En 271 (27,8%) mujeres, se observaron discrepancias entre el análisis de la cadera total y el cuello femoral. La frecuencia de osteoporosis osciló entre el 3% cuándo se consideró sólo los resultados de la cadera total y el 16% cuando se tuvo en cuenta los valores del análisis de L2-L4 y del tercio proximal del fémur (cadera total o cuello femoral) . Conclusiones: La frecuencia de osteoporosis varía notablemente según la región esquelética considerada (AU)

Objective: To analyze the differences in the frequency of osteoporosis according to the skeletal site evaluated in a group of Spanish postmenopausal women. Methods: We reviewed the data of 987 postmenopausal women (mean age, 53.8±5.5 years). BMD status was evaluated by DXA. We used the WHO thresholds to classify the patients. T-score was obtained from the single evaluation of each lumbar vertebra (L2, L3 and L4), the mean value of lumbar spine (L2-L4), femoral neck and total hip. Results:In 144 (14.7%) women, discrepancies were observed when we considered the single vertebral analysis versus the L2-L4 analysis; 62 (6%) women who presented osteoporosis in at least one vertebra would have been due to the osteopenia category when L2-L4 value was selected. In 271 (27.8%) women, discrepancies were observed when we considered the total hip analysis versus the femoral neck analysis. The frequency of osteoporosis ranged from 3% when only the analysis of the total hip was considered to 16% when the results of L2-L4 and proximal femur (total hip or femoral neck) measurements were selected. Conclusions: Frequency of osteoporosis varies notably according to the skeletal zone considered (AU)

Osteoporosis transitoria de cadera en una gestante / Transient coxal osteoporosis of pregnancy

La osteoporosis transitoria de cadera es un fenómeno inusual en las unidades de cuidados críticos y de urgencias en relación con la patología traumatológica en pacientes ginecológicas y que cada vez es más frecuente, dentro del diagnóstico diferencial de la coxalgia de perfil mecánico. Al enfrentarnos ante cuadros sindrómicos de tal amplitud, no debemos olvidar la existencia de enfermedades inusuales en nuestro medio. Presentamos un caso clínico de una paciente con dolor inguinal cuya etiología era una osteoporosis transitoria de cadera. Así mismo realizamos una revisión de la literatura sobre la clínica, diagnóstico y tratamiento de esta enfermedad (AU)

Transient osteoporosis of the hip is an uncommon disorder. The etiology is unclear and it coud be confused with other diagnosis as femoral head osteonecrosis. We present a case report of a woman with transient osteoporosis of the hip. We also perform a literature review. The goal of this paper is to provide physicians how to diagnose and treat this disease (AU)

Efecto de la edad y de la menopausia sobre la masa ósea / Effect of age and menopause on bone mass

Objetivos. Estudiar la variación en la pérdida de masa ósea que se produce en la columna lumbar y cadera durante los años previos a la aparición de la menopausia y durante la misma. Material y método. Análisis prospectivo de la masa ósea mediante densitometría ósea a mujeres sin medicación previa. Resultados. Estudio de 316 mujeres, el 81,6% con menopausia. Existe relación lineal negativa significativa entre la masa ósea y la menopausia en la columna lumbar y la cadera, con una fuerza de relación homogénea en la columna lumbar, siendo ésta más intensa en la cadera. Al nivel lumbar se aprecia una pérdida de hueso global del 17,6%, siendo más rápida en los 10 primeros años; en la cadera el porcentaje de pérdida es mayor. Discusión. Existe importante pérdida de masa ósea con la menopausia, mayor que la esperable sólo por la edad, más intensa en triángulo de Ward seguido del cuello, trocánter y columna lumbar; esto mismo aunque en menor intensidad ocurre en la época de la premenopausia

Objectives. To study the variation in bone loss in the lumbar spine and hip during pre- and postmenopausal periods. Material and method. Prospective analysis of the bone mass assessing the bone mineral density in women without previous medication. Results. Three hundred-sixteen women were studied, 81.6% of them were menopausal. We found a statistically significant negative linear correlation at lumbar spine and hip in all locations, with a homogenous force in lumbar spine, this being the most intense in the hip. On the lumbar level there was a decrease of 17.6% of the global bone mass, this loss being faster during the first ten years. The loss was greater in the hip. Conclusions. There is a clear loss of bone mass during the menopause, greater than that expected only due to age. The location with the most bone loss is the Ward's triangle, followed by the neck and the trocanter of the hip and the lumbar spine. The same, although on a smaller scale, was found during premenopause

Abordagem diagnóstica das síndromes dolorosas do quadril no adulto / Diagnostic boarding of the painful syndromes of the hip in the adult

Este artigo de revisão tem como objetivo apresentar um estudo das causas mais comuns de dor na região do quadril do adulto e propor uma adequada avaliação clínica, no intuito de identificar as etiologias mais freqüentes das patologias específicas do quadril.