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Bike fitting aims to optimize riders' positions to improve their performance and reduce the risk of injury. To calculate joint angles, the location of the joint centers of the lower limbs needs to be identified. However, one of the greatest difficulties is the location of the hip joint center due to the frequent occlusion of the anterior superior iliac spine markers. Therefore, the objective of this study was to validate a biomechanical model adapted to cycling (modified pelvic model, MPM), based on the traditional pelvic model (TPM) with an additional lateral technical marker placed on the iliac crests. MPM was also compared with a widely used model in cycling, trochanter model (TM). Thirty-one recreational cyclists pedaled on a roller bike while the movement was captured with a 7-camera VICON system. The position of the hip joint center and knee angle were calculated and compared with the TPM continuously (along 10 pedaling cycles) and discreetly at 90° and 180° crank positions. No significant differences were found in the position of the hip joint center or in the knee flexion/extension angle between the TPM and the MPM. However, there are differences between TPM and TM (variations between 4.1° and 6.9° in favor of the TM at 90° and 180°; P <.001). Bland–Altman graphs comparing the models show an average difference or bias close to 0° (limits of agreement [0.2 to −8.5]) between TPM and MPM in both lower limbs and a mean difference of between −4° and −7° (limits of agreement [−0.6 to −13.2]) when comparing TPM and TM. Given the results, the new cycling pelvic model has proven to be valid compared with the TPM when performing bike fitting studies, with the advantage that the occluded markers are avoided. Despite its simplicity, the TM presents measurement errors that may be relevant when making diagnoses, which makes its usefulness questionable. [ABSTRACT FROM AUTHOR]

BACKGROUND: Lumbopelvic movement patterns during prone hip extension has been proposed as a clinical screening method for trunk muscle dysfunction in patients with chronic low back pain (CLBP). However, correlations between trunk muscle onset and pelvic kinematics have not been investigated. OBJECTIVE: To examine the correlation between trunk muscle onset and pelvic kinematics during prone hip extension in participants with CLBP. METHODS: Fifteen patients with CLBP and 15 healthy individuals participated. We evaluated the muscle activities of the lumbar multifidus, the longissimus, and the semitendinosus via electromyogram and the displacement angles of the pelvic tilt, oblique and rotation. RESULTS: The onset of the multifidus at the ipsilateral side of hip extension was significantly delayed in the patients with CLBP compared to the control group (P < 0.001). The onset of the ipsilateral multifidus in the control group was significantly correlated with increased anterior pelvic tilt angle (P = 0.019, r = 0.597), whereas no significant correlation was observed in the CLBP group (P = 0.810, r = - 0.068). CONCLUSION: The results suggest that pelvic kinematics during prone hip extension does not predict the delayed trunk muscle onset in patients with CLBP. [ABSTRACT FROM AUTHOR]

Background: Individual maximum joint and segment angular velocities have shown positive associations with throwing arm kinetics and ball velocity in baseball pitchers. Purpose: To observe how cumulative maximum joint and segment angular velocities, irrespective of sequence, affect ball velocity and throwing arm kinetics in high school pitchers. Study Design: Descriptive laboratory study. Methods: High school (n = 55) pitchers threw 8 to 12 fastball pitches while being evaluated with 3-dimensional motion capture (480 Hz). Maximum joint and segment angular velocities (lead knee extension, pelvis rotation, trunk rotation, shoulder internal rotation, and forearm pronation) were calculated for each pitcher. Pitchers were classified as overall fast, overall slow, or high velocity for each joint or segment velocity subcategory, or as population, with any pitcher eligible to be included in multiple subcategories. Kinematic and kinetic parameters were compared among the various subgroups using t tests with post hoc regressions and multivariable regression models created to predict throwing arm kinetics and ball velocity, respectively. Results: The lead knee extension and pelvis rotation velocity subgroups achieved significantly higher normalized elbow varus torque (P =.016) and elbow flexion torque (P =.018) compared with population, with equivalent ball velocity (P =.118). For every 1-SD increase in maximum pelvis rotation velocity (87 deg/s), the normalized elbow distractive force increased by 4.7% body weight (BW) (B = 0.054; β = 0.290; P =.013). The overall fast group was older (mean ± standard deviation, 16.9 ± 1.4 vs 15.4 ± 0.9 years; P =.007), had 8.9-mph faster ball velocity (32.7 ± 3.1 vs 28.7 ± 2.3 m/s; P =.002), and had significantly higher shoulder internal rotation torque (63.1 ± 17.4 vs 43.6 ± 12.0 Nm; P =.005), elbow varus torque (61.8 ± 16.4 vs 41.6 ± 11.4 Nm; P =.002), and elbow flexion torque (46.4 ± 12.0 vs 29.5 ± 6.8 Nm; P <.001) compared with the overall slow group. A multiregression model for ball velocity based on maximum joint and segment angular velocities and anthropometrics predicted 53.0% of variance. Conclusion: High school pitchers with higher maximum joint and segment velocities, irrespective of sequence, demonstrated older age and faster ball velocity at the cost of increased throwing shoulder and elbow kinetics. Clinical Relevance: Pitchers and coaching staff should consider this trade-off between faster ball velocity and increasing throwing arm kinetics, an established risk factor for elbow injury. [ABSTRACT FROM AUTHOR]

The purpose of this study was to clarify the relationship between the efficiency of mechanical energy flow in the torso and bat head speed at impact. Ninety-eight amateur baseball players batted a light ball tossed from the pitcher direction 3.2 m away. The batting motion and ground reaction forces acting on each foot were recorded using a motion capture system and two force plates, respectively. The mechanical powers of the joint forces and joint torques were calculated to measure the generation, absorption, and transfer of mechanical energy in the torso. The transfer efficiency of mechanical energy in the torso was defined as the ratio of the mechanical energy inflow into the thorax from the torso joint to the mechanical energy outflow from the pelvis to the torso joint. The correlation coefficient between the bat head speed and transfer efficiency of mechanical energy in the torso was very low. Conversely, the mechanical energy flow in the torso was significantly correlated to the bat head speed. Therefore, the results suggest that the torso in baseball batting is not utilised for the generation of mechanical energy but acts as a pathway for the transfer of mechanical energy. [ABSTRACT FROM AUTHOR]

Asymmetry in knee extensor moment during double-leg squatting was observed after anterior cruciate ligament reconstruction, even after the completion of the rehabilitation program for return to sports. The purpose of this study was to clarify the association between asymmetry in the knee extensor moment and pelvic rotation angle during double-leg squatting after anterior cruciate ligament reconstruction. Twenty-four participants performed double-leg squatting. Kinetics and kinematics during squatting were analyzed using a 3-dimensional motion analysis system with 2 force plates. The limb symmetry index of knee extensor moment was predicted by the pelvic rotation angle (R2 =.376, P =.001). In addition, the pelvic rotation and the limb symmetry index of the vertical ground reaction force independently explained the limb symmetry index of the knee extensor moment (R2 =.635, P <.001, β of pelvic rotation = −0.489, β of vertical ground reaction force = 0.524). Pelvic rotation toward the involved limb was associated with a smaller knee extensor moment in the involved limb than in the uninvolved limb. The assessment of pelvic rotation would be useful for partially predicting asymmetry in the knee extensor moment during double-leg squatting. Minimizing pelvic rotation may improve the asymmetry in the knee extensor moment during double-leg squatting after anterior cruciate ligament reconstruction. [ABSTRACT FROM AUTHOR]

In addition to pain, specific low back pain is frequently accompanied by restricted range of motion (ROM) during gait. To compare the behavior of kinematic and spatiotemporal gait parameters, pain, functional status, and self-efficacy, in patients with a diagnosis of herniated disk or lumbar stenosis undergoing surgery, in the pre- and postoperative periods of 1 and 6 months (PO6). Seven participants and 11 control subjects were assessed. A kinematics system comprising 10 optoelectronic cameras was used to assess gait. The Roland-Morris questionnaire, pain intensity, and self-efficacy, over three periods, were used. The ROM of the pelvis, hip, and knee of the hernia group presented an increase after surgery and the stenosis group presented a reduction of values in the hip. During the stance phase, the pelvis and hip ROM of both groups remained smaller than the control group. There was improvement in pain in individuals with hernia and stenosis (effect size = 0.6 and 0.8, respectively) in the three analyzed moments; for functional status there was improvement in the first postoperative period (ES = 0.4) compared to the preoperative in those individuals with hernia; and those with stenosis had improvement at PO6 when compared to the time before the surgery (ES = 0.2). Surgical intervention modifies the spatiotemporal parameters, the ROM of the pelvis, hip, and knee in the total gait cycle, primarily in the sagittal plane, and causes alterations, particularly in the hip joint, in these individuals during the support phase. [ABSTRACT FROM AUTHOR]

Introduction: Extra-articular hip resection may be necessary in cases of malignant tumour of the pelvic bone or of the proximal femur invading the hip joint. When the tumour is in the proximal femur, it is possible to resect the acetabulum en bloc by performing a periacetabular osteotomy, but this creates a discontinuity in the pelvic ring with difficult reconstruction and diminished function. Several techniques described recently seek to be as sparing as possible on the pelvic bone by preserving the posterior column or both columns in order to facilitate reconstruction and improve function. However, these still require complex reconstructions and can necessitate intra-pelvic dissection. Technique: We describe here an extra-articular hip resection technique for tumours of the proximal femur invading the joint, with maintenance of pelvic continuity by preserving both columns and the quadrilateral plate of the acetabulum, without intra-pelvic dissection, that can be performed on patients in whom the medial wall of the acetabulum is thick enough. Our preliminary assessments have included studies on dry bone and imaging analyses. The technique was first tested on a single cadaver pelvis (encompassing 2 hips) and subsequently performed on a patient with a pathological fracture of the femoral neck due to osteosarcoma secondary to Paget's disease. Conclusions: Further clinical applications are essential to evaluate the overall effectiveness, safety and impact on patient functionality of this experimental technique. [ABSTRACT FROM AUTHOR]

Introduction: Reconstruction of a cloacal defect in a girl is often difficult and complicated.[1] This is most often done either by the sacro-perineal route or through the posterior sagittal route.[2] The procedures may involve total mobilization of the cloaca with or without the creation of a lower vagina with the help of a loop of vascularized bowel.[3] In our approach, such defects can be corrected using the lower anorectum for the creation of a lower vagina and abdominoperineal pull-through of the proximal divided bowel. This method can be used both in short and long common channel cloaca. Materials and Methods: We have used this procedure in one patient of posterior cloaca and four patients of anterior cloaca. These operations were done in patients of 1 year and 6 months to 4 years. Only one patient is waiting for the closure of the colostomy. Results: In all the cases, the urethra, the vagina, and the anus were successfully separated. Conclusion: This operation restores normal pelvic anatomy and physiology with minimal mutilation of the pelvic floor. [ABSTRACT FROM AUTHOR]

Background: Optimal management and surgical planning of severe bony deformities and muscle tendon unit contractures demands comprehensive evaluation of all structures including the dynamic muscle tendon length of all muscles around the joint during gait. Objectives: Present study aimed to explore dynamic muscle–tendon length for all muscles around the knee joint along with pelvis, hip, and ankle joint kinematics among adolescent children with varying crouch angle. Methods: Muscle–tendon length of 29 adolescent children with cerebral palsy with varying crouch angles was computed using a full-body musculo-skeletal model and expressed as a percentage of muscle–tendon length during walking compared to resting condition. Results: Children with knee flexion angle greater than 25° demonstrated lower anterior pelvic tilt and 11% greater muscle–tendon length of semimembranosus and biceps femoris during stance phase of gait compared to children with knee flexion angle less than 25° and typically developing children (p < 0.01). Conclusions: The findings of present study reported that routine bedside clinical evaluation in adolescent children with knee flexion angle greater than 25° revealed moderate shortening of hamstring muscle in supine position. Whereas instrumented objective evaluation of gait demonstrated lengthened hamstring muscle and reduced hip extension and relatively lower anterior pelvic tilt. Therefore, it may be valuable to add objective assessment of dynamic muscle–tendon length to kinematics of all lower-extremity joint motion during gait, in order to understand the muscle–joint interactions; particularly in children with severe crouch and plan specific, tailor-made surgical and non-surgical interventions. [ABSTRACT FROM AUTHOR]

Introduction: Pelvic ring fractures, particularly those involving the posterior pelvis, pose significant challenges due to their inherent instability. The posterior pelvic ring is critical in providing structural support and stability to the pelvis. This study evaluates the functional outcomes and health-related Quality of life (HRQOL) of patients who underwent internal fixation for unstable pelvic fractures. Various factors influencing the outcomes are also investigated. Material and Methods: A single-center cross-sectional study was conducted on patients with unstable sacral fractures treated with posterior tension band plate or sacroiliac plating with or without symphyseal plating between 2016 and 2020. Patient demographics, injury mechanisms, associated injuries, surgical details, complications, and return-to-work data were collected. HRQOL was assessed using specific pelvic fracture instruments and general HRQOL questionnaires. Logistic regression analysis was performed to identify factors associated with lower SF-12 and SF-36 scores Results: The study included 54 patients, predominantly males (55.6%), aged 18–70 years, with high-energy trauma mechanisms, such as road traffic accidents and occupational injuries. The majority of patients had lateral compression pelvic fractures. Overall, the functional outcomes were favorable, with excellent or good outcomes observed in 86.1% of cases. Patients with associated injuries, such as abdominal, chest, or head injuries, were likelier to have lower SF-12 physical component scores. Sexual satisfaction scores remained stable for most patients post-surgery. Discussion: This study highlights the favorable functional outcomes and HRQOL for patients undergoing fixation for unstable pelvic ring fractures. Younger, working-age males were the most commonly affected demographic. Associated injuries significantly affected physical HRQOL scores. Despite high-energy trauma, patients generally reported satisfactory sexual function post-surgery [ABSTRACT FROM AUTHOR]

The purpose of study was to compare the kinematic patterns of the thoracic, lumbar, and pelvis segments and hip joints between 2 low back pain subgroups and healthy women during sit-to-stand and stand-to-sit. Kinematic data of 44 healthy women and 2 subgroups of females with low back pain in 2 subgroups of movement system impairment model (rotation-extension [Rot.Ext] and rotation-flexion [Rot.Flex]) were recorded. Participants performed sit-to-stand and stand-to-sit at a preferred speed. Each task was divided into a pre buttock lifted off/on (pre-BOff/n) phase and a post-BOff/n phase. The Rot.Ext subgroup showed greater range of motion in the thoracic during pre-BOff phase of sit-to-stand (P <.001) and pre-BOn phase of stand-to-sit (P =.01) compared to the other 2 groups. The Rot.Flex subgroup displayed limited left hip joint excursion during sit-to-stand pre-BOff (P =.04) and stand-to-sit post-BOn phases (P =.02). The Rot.Flex subgroup showed greater pelvis tilt excursion during sit-to-stand post-BOff (P =.04) and stand-to-sit pre-BOn (P =.01) and post-BOn phases (P =.01). In subgroups of women with chronic low back pain, there were kinematic changes in adjacent body segments/joints of lumbar spine during sit-to-stand and stand-to-sit tasks. [ABSTRACT FROM AUTHOR]

The biomechanical relationship between horse and rider in equine-assisted activities and therapies has been largely unexplored. The three-dimensional stimulation of the horse's gait has potential to improve rider musculature and coordination, especially in an older adult population. This study utilized dual-axis goniometers and video motion capture tracking to simultaneously track horse and rider hip flexion and extension. Ten older adult riders participated in 8 weeks of horseback riding lessons, where pelvis kinematics and balance assessments were compared between Weeks 1 and 8. Pelvic roll of the rider and horses' hip flexion and extension were successfully tracked and summed improvements in balance assessments were also evident after 8 weeks of horseback riding lessons. Future research will assess deeper kinematic relationships between a horse's gait and rider biomechanical responses. [ABSTRACT FROM AUTHOR]

Background: Debates persist over optimal pelvic girdle reconstruction after acetabular tumor resection, with surgeons grappling between modular and 3D-printed hemipelvic endoprostheses. We hypothesize superior outcomes with 3D-printed versions, yet scarce comparative research exists. This study fills the gap, examining biomechanics and clinical results retrospectively. Methods: From February 2017 to June 2021, we retrospectively assessed 32 patients undergoing en bloc resection for malignant periacetabular tumors at a single institution. Primary outcome: limb function. Secondary outcomes: implant precision, hip joint rotation center restoration, prosthesis-bone osteointegration, and complications. Biomechanical characteristics were evaluated through finite element analysis on pelvic defect models. Results: In the 3D-printed group, stress distribution mirrored a normal pelvis, contrasting the modular group with elevated overall stress, unstable transitions, and higher stress peaks. The 3D-printed group exhibited superior functional scores (MSTS: 24.3 ± 1.8 vs. 21.8 ± 2.0, p < 0.05; HHS: 79.8 ± 5.2 vs. 75.3 ± 3.5, p < 0.05). Prosthetic-bone interface osteointegration, measured by T-SMART, favored 3D-printed prostheses, but surgery time (426.2 ± 67.0 vs. 301.7 ± 48.6 min, p < 0.05) and blood loss (2121.1 ± 686.8 vs. 1600.0 ± 505.0 ml, p < 0.05) were higher. Conclusions: The 3D-printed hemipelvic endoprosthesis offers precise pelvic ring defect matching, superior stress transmission, and function compared to modular endoprostheses. However, complexity, fabrication expertise, and challenging surgical implantation result in prolonged operation times and increased blood loss. A nuanced consideration of functional outcomes, complexity, and patient conditions is crucial for informed treatment decisions. Level of evidence: Level III, therapeutic study (Retrospective comparative study). [ABSTRACT FROM AUTHOR]

This study aimed to investigate inter- and intra-athlete technique variability in pre-elite and elite Australian fast bowlers delivering new ball conventional swing bowling. Ball grip angle and pelvis, torso, shoulder, elbow, wrist, upper arm, forearm, and hand kinematics were investigated at the point of ball release for inswing and outswing deliveries. Descriptive evaluations of group and individual data and k-means cluster analyses were used to assess inter- and intra-bowler technique variability. Inter-athlete technique and ball grip variability were identified, demonstrating that skilled bowlers use individualised strategies to generate swing. Functional movement variability was demonstrated by intra-athlete variability in successful swing bowling trials. Bowlers demonstrated stable technique parameters in large proximal body segments of the pelvis and torso, providing a level of repeatability to their bowling action. Greater variation was observed in bowling arm kinematics, allowing athletes to manipulate the finger and ball position to achieve the desired seam orientation at the point of ball release. This study demonstrates that skilled bowlers use individualised techniques and grips to generate swing and employ technique variations in successive deliveries. Coaches should employ individualised training strategies and use constraints-led approaches in training environments to encourage bowlers to seek adaptive movement solutions to generate swing. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic reverse submucosal dissection (LRSD) is a standardised surgical technique for removal of rectosigmoid endometriosis which optimises the anatomical dissection plane for excision of endometriotic nodules. Aim: This cohort study assesses the outcomes of the first cohort of women treated by LRSD, for deeply infiltrating rectosigmoid endometriosis. Materials and Methods: Primary outcomes assessed were complication rate as defined by the Clavien–Dindo system, and completion of the planned LRSD. Secondary outcomes include mucosal breach, specimen margin involvement, length of hospital admission, and a comparison of pre‐operative and post‐operative pain, bowel function and quality of life surveys. These included the Endometriosis Health Profile Questionnaire (EHP‐30), the Knowles‐Eccersley‐Scott Symptom Questionnaire (KESS) and the Wexner scale. Results: Of 19 patients treated, one required a segmental resection. The median length of hospital admission was two days (range 1–5) and no post‐operative complications occurred. Median pain visual analogue scales (scale 0–10) were higher prior to surgery (dysmenorrhoea 9.0, dyspareunia 7.5, dyschezia 9.0, pelvic pain 6.0) compared to post‐surgical median scores (dysmenorrhoea 5.0, dyspareunia 4.0, dyschezia 2.0, pelvic pain 4.0) at a median of six months (range 4–32). Quality of life studies suggested improvement following surgery with pre‐operative median EHP‐30 and KESS scores (EHP‐30: 85 (5–106), KESS score 9 (0–20)) higher than post‐operative scores (EHP‐30: 48.5 (0–80), KESS score: 3 (0–19)). Conclusion: This series highlights the feasibility of LRSD with low associated morbidity as a progression of partial thickness discoid excision (rectal shaving) for the treatment of rectosigmoid deep infiltrating endometriosis. [ABSTRACT FROM AUTHOR]

Objective. Lumbopelvic stability and shooting accuracy are some of the key determinants in the performance of archers. This study aimed to investigate the effect of Pilates exercise intervention combined with balance training on lumbopelvic stability and shooting accuracy in national level archers. Methods. A randomized control trial with pre-test and post-test control group design was conducted with thirty male professional archers between the ages of 18-30 years. The participants were randomly allocated into three groups (ten in each group: PB = Balance and Pilates exercises; B = Balance Exercises; C = No exercises). The lumbopelvic stability was determined using the Knee Lift Abdominal Test (KLAT) and Bent Knee Fall-Out Test (BKFOT) for both legs by using a pressure biofeedback unit. Shooting accuracy was measured by taking the score of two ends with 12 arrows. Baseline measurements were taken before given intervention. The training program was given for 20 minutes a day and three times per week for six weeks. Results. One-way ANOVA showed significant difference in shooting accuracy (F = 5.11, ηp² = 0.159, p = 0.03), KLAT (Right) (F = 8.51, ηp² = 0.240, p = 0.00), KLAT (Left) (F = 6.62, ηp² = 0.187, p = 0.01) and BKFOT (Left) (F = 6.31, ηp² = 0.195, p = 0.01). Whereas no significant difference is shown in BKFOT (Right) (F = 0.99, ηp² = 0.035, p = 0.33) among B, PB, and Control group for baseline measurement and after intervention. Conclusions. Although balance training showed improvements in the post-test values, the most significant improvements were recorded in the Pilates plus balance training group. This information can be used to plan the training protocols for archers. [ABSTRACT FROM AUTHOR]

As an essential lower-back movement pattern, lumbo-pelvic rhythm (LPR) during forward trunk flexion and backward return has been investigated on a large scale. It has been suggested that abnormalities in lumbo-pelvic coordination are related to the risk of developing low back disorders. However, considerable differences in the approaches used to monitor LPR make it challenging to integrate findings from those investigations for future research. Therefore, the aim of this systematic review was to summarize the use of wearable technology for kinematic measurement with sensory biofeedback for LPR monitoring by assessing these technologies' specific capabilities and biofeedback capacities and exploring their practical viability based on sensor outcomes. The review was developed following the PRISMA guidelines, and the risk of bias was analyzed using the PREDro and STROBE scales. PubMed, Web of Science, Scopus, and IEEEXPLORE databases were searched for relevant studies, initially returning a total of 528 articles. Finally, we included eight articles featuring wearable devices with audio or vibration biofeedback. Differences in protocols and limitations were also observed. This novel study presents a review of wearable tracking devices for LPR motion-mediated biofeedback for the purpose of correcting lower back posture. More research is needed to determine the long-term effectiveness of these devices, as well as their most appropriate corresponding methodologies. [ABSTRACT FROM AUTHOR]

The purpose was to compare two non-laboratory based running retraining programs on lower limb and trunk kinematics in recreational runners. Seventy recreational runners (30 ± 7.3 years old, 40% female) were randomised to a barefoot running group (BAR), a group wearing a digital metronome with their basal cadence increased by 10% (CAD), and a control group (CON). BAR and CAD groups included intervals from 15 to 40 min over 10 weeks and 3 days/week. 3D sagittal kinematics of the ankle, knee, hip, pelvis, and trunk were measured before and after the retraining program, at comfortable and high speeds. A 3 × 2 mixed ANOVA revealed that BAR and CAD groups increased knee and hip flexion at footstrike, increased peak hip flexion during stance and flight phase, decreased peak hip extension during flight phase, and increased anterior pelvic tilt at both speeds after retraining. In addition, BAR increased ankle plantar flexion at footstrike and increased anterior trunk tilt. Both retraining programs demonstrated significant moderate to large effect size changes in parameters that could reduce the mechanical risks of injury associated with excessive knee stress, which is of interest to coaches, runners and those prescribing rehabilitation and injury prevention programs. [ABSTRACT FROM AUTHOR]

BACKGROUND: Previous studies have suggested an association between pelvic rotation (PR) and scoliotic deformity in severe adolescent idiopathic scoliosis (AIS), but none have investigated this relationship in mild to moderate AIS. OBJECTIVE: To investigate the relationship between PR and trunk rotation in mild to moderate AIS. METHODS: This was a case-control study. The cases were 32 AIS patients with PR in the opposite direction to the thoracic curve, and the controls were 32 AIS patients with PR in the same direction as the thoracic curve. All patients were assessed with the Adams forwards bend test. Type II trunk rotation was selected as exposure. Logistic regression was used to estimate the association between PR direction and types of trunk rotation while accounting for confounders. Multiple linear regression was used to analyse the relationships between PR magnitude and the angle of trunk rotation (ATR). RESULTS: Logistic regression showed an unadjusted OR of 9.13 (95% CI 2.92–28.50, P < 0.001), and adjustment for sex and Cobb angle only slightly changed the OR (adjusted OR, 8.23; 95% CI, 2.51–27.01; P = 0.001). The concave/convex ratio was associated with ATR measurements in both cases (β = - 0.379; P = 0.030) and controls (β = - 0.468, P = 0.008). CONCLUSION: An association was found between PR and trunk rotation, which may help achieve more effective physiotherapy in mild to moderate AIS. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to compare three-dimensional kinematic of the trunk, pelvis, hip, and knee during the single-leg squat and hip torque in individuals with and without isolated patellofemoral osteoarthritis (PFOA). Patients and methods: This cross-sectional study evaluated trunk, pelvis, hip, and knee kinematics at 30°, 45°, and 60° knee flexion during the single-leg squat using the Vicon motion capture and analysis system, the Nexus System 2.1.1, and 3D Motion Monitor software. Sixteen individuals (8 males, 8 females; mean age: 49.3±6.2 years; range 40 to 61 years) participated in the study, of which eight were PFOA patients and eight were healthy controls. Isometric hip abductor, extensor, and external rotator torques were evaluated using a handheld dynamometer. Results: The PFOA group exhibited greater hip adduction at 30° (p=0.008), 45° (p=0.005), and 60° (p=0.008) knee flexion in the descending phase of the single-leg squat, as well as at 60° (p=0.009) and 45° (p=0.03) knee flexion in the ascending phase. No significant differences were found between groups for other kinematic variables (p>0.05). The PFOA group exhibited lower isometric hip abductor (p=0.02), extensor (p<0.001), and external rotator (p=0.007) torques. Conclusion: Individuals with PFOA exhibited excessive hip adduction that could increase stress on the lateral patellofemoral joint at 30°, 45°, and 60° knee flexion during the single-leg squat and exhibited weakness of the hip abductors, extensors, and external rotators in comparison to healthy controls. [ABSTRACT FROM AUTHOR]

A pitcher's ability to achieve pitch location precision after a complex series of motions is of paramount importance. Kinematics have been used in analyzing performance benefits like ball velocity, as well as injury risk profile; however, prior utilization of such data for pitch location metrics is limited. To develop a pitch classifier model utilizing machine learning algorithms to explore the potential relationships between kinematic variables and a pitcher's ability to throw a strike or ball. This was a descriptive laboratory study involving professional baseball pitchers (n = 318) performing pitching tests under the setting of 3D motion-capture (480 Hz). Main outcome measures included accuracy, sensitivity, specificity, F1 score, positive predictive value (PPV), and negative predictive value (NPV) of the random forest model. The optimized random forest model resulted in an accuracy of 70.0 %, sensitivity of 70.3 %, specificity of 48.5 %, F1 equal to 80.6 %, PPV of 94.3 %, and a NPV of 11.6 %. Classification accuracy for predicting strikes and balls achieved an area under the curve of 0.67. Kinematics that derived the highest % increase in mean square error included: trunk flexion excursion(4.06 %), pelvis obliquity at foot contact(4.03 %), and trunk rotation at hand separation(3.94 %). Pitchers who threw strikes had significantly less trunk rotation at hand separation(p = 0.004) and less trunk flexion at ball release(p = 0.003) compared to balls. The positive predictive value for determining a strike was within an acceptable range, while the negative predictive value suggests if a pitch was determined as a ball, the model was not adequate in its prediction. Kinematic measures of pelvis and trunk were crucial determinants for the pitch classifier sequence, suggesting pitcher kinematics at the proximal body segments may be useful in determining final pitch location. [ABSTRACT FROM AUTHOR]

Background: Postural alignment impairments can be observed after acquired brain injury (ABI) and may be more prevalent in people with greater mobility impairment. However, investigations of postural alignment are limited by the lack of an evaluated method of assessment. This study examined postural alignment differences between healthy adults and adults with ABI, and evaluated repeatability of a new kinematic method for measuring postural alignment. Methods: Observational study of 14 adults with ABI who were non-ambulant at eight weeks post-injury, and 14 healthy adults. 3D kinematic data were recorded using motion capture technology in sitting and standing, on two separate days. A new Postural Alignment and Dispersion (PAD) score quantified average body segment displacements from the base of support (BoS) in the transverse plane. The two groups' PAD scores were compared. Repeatability of the PAD score between days was evaluated using intraclass correlation coefficients (ICCs). Major findings: Greater postural alignment deviations were observed after ABI, including marked deficits in frontal and sagittal planes. ICCs ranged moderate (0.614) to excellent (0.945). Wide confidence intervals (CIs) for some ICCs indicated that repeatability of PAD scores could not be assured for all sitting and standing conditions. Conclusions: Postural alignment impairments occur in multiple planes after ABI and can be pronounced in people with severe mobility impairment. Evidence is needed to determine if addressing postural alignment impairments affects functional progress after ABI. PAD score measurement requires further evaluation to determine how repeatability can be optimised. [ABSTRACT FROM AUTHOR]

The instant of foot contact is an important transition point during the pitch cycle between the linear portion of the pitch, as a pitcher strides down the mound and the rotational portion of the pitch. Understanding the implications of lead foot angle at foot contact is an essential information needed to assist pitching coaches in their work with individual pitchers. Therefore, the purpose of this study was to determine the association between lead foot progression angle at foot contact and ball velocity, elbow varus moment, and pelvic rotation. Kinematic and kinetic data were collected from 99 collegiate pitchers and analyzed using a random intercept, mixed-effects regression model. Significant associations were found between lead foot progression angle at foot contact and elbow varus moment (P =.004), as well as pelvic rotation throughout the pitching motion (P <.001). The data indicate that increased lead foot internal rotation at foot contact is associated with increases in the elbow varus moment but is not associated with ball velocity. This study provides scientific evidence that the rotational positioning of the lead foot can affect both pelvic motion and upper-extremity joint moments. [ABSTRACT FROM AUTHOR]

Objectives: Femoroacetabular Impingement (FAI) is the primary clinical indication for hip arthroscopy. FAI can occur due to a bony deformity on the femur, known as a cam, or on the acetabular rim, referred to as a pincer. The bony deformity causes a painful hip, and results in limited hip motion and soft tissue damage. The patients' posture can influence impingement; specifically, forward pelvic tilt may exaggerate impingement. The patient's natural pelvic tilt can be observed in standing radiographs. However, radiographs do not provide as much information about bony deformity as 3D imaging. 3D imaging is acquired in a supine rather than standing position, and therefore does not represent the physiological posture of the patient. Previous research focused on how changes in pelvic tilt change radiographic measurements of the hip, but how much pelvic tilt influences other 3D morphological analyses remains unclear. The objective of this study is to assess how pelvic tilt influences 3D morphological analyses of the hip through systematic simulation of various levels of pelvic tilt. Additionally, it investigated how distance/angle measurements between anatomical features are impacted by pelvic tilt. Methods: Twenty CT (Computed Tomography) scans of patients (14 female, 6 male, age range 18-56 years) with hip pain (3 cam, 3 pincer, 4 combined, 6 hip instabilities, 4 no cam or pincer presence) collected through an IRB (Institutional Review Boards) were used in this study. Three-dimensional surface reconstructions were virtually adjusted based on the anterior pelvic plane to obtain samples with a pelvic tilt between 20° anterior and 20° posterior inclination in steps of 5 degrees using 3-matic Medical (Materialize). Three-dimensional morphological analyses were obtained through HipMap software (Stryker) and included: center edge angle (CEA), acetabular version (at three levels: AV12, AV2, AV3), Tönnis angle (TA), alpha angles (12, 1, 2, 3), femoral torsion, acetabular coverage, combined version. Furthermore, anatomical measurements such as the vertical distance between the ASIS (Anterior Superior Iliac Spines) landmarks and the femoral head center (FHC), inclination, anteversion tilt and rotation angles between aligned and virtually adjusted orientations were calculated using 3-matic Medical (Materialize). Additionally, similar radiographic measurements of anatomical features as mentioned above were obtained by mapping landmarks of a statistical shape model onto actual hip surfaces (n=641) and simulating pelvic tilt using proprietary software (SOMA (Stryker Orthopedic Modeling and Analytics)). Statistical data analyses assess the impact of pelvic tilt on morphological and anatomical measurements including correlations, distribution, ANOVA, and intra-class correlation (ICC) using Python. Results: Pelvic tilt influenced all acetabular and none of the femoral measurements (Figure 1). The ICC was 1.0 for alpha angle and for femoral torsion, indicating no impact of pelvic tilt on the measurements. The ICC were 0.97, 0.96, 0.89 for TA, CEA, and acetabular coverage respectively, indicating a minor impact of pelvic tilt. In contrast, the ICC for AV12 was 0.17, AV2 0.24, AV3 0.24 showing a strong impact of pelvic tilt on acetabular version. There was a positive correlation between the pelvic tilt angle and acetabular version (R2=0,69, p<0.01 for AV12; R2=0,61, p<0.01 for AV3; R2=0,49, p<0.01 for AV12). The impact of pelvic tilt on the acetabular measurements was non-linear. For example, anterior inclination resulted in greater differences in acetabular version (on average 21° for AV12, 19° for AV2, 18° for AV3) than posterior inclination (on average 28° for AV12, 14° for AV2, 12° for AV3), but increased on average 3° per 1° of anterior inclination (Figure 2ad). For CEA the maximum change of measurement between -20° to 20° is 6.2°, with a larger difference between 20° anterior tilt and no tilt (4.9°) than between 20° posterior tilt and no tilt (1.3°) (Figure 2be). The average difference in TA was 0.2° for anterior and 1.3° for posterior tilt. For acetabular coverage the difference between -20° and 20° tilt was –11.32% (Figure 2cf). For every 1° tilt the vertical ASIS-FHC distance reduced 0.54 mm on average (Figure 3ac). The angle between the transverse plane and line between the pubic symphysis and posterior superior iliac spine was directly correlated (R2=1, p<0.01) to the pelvic tilt angle (Figure 3bd). Conclusions: Pelvic tilt impacts morphological hip measurements (especially acetabular version) and can lead to measurement differences between aligned CT, unaligned CT and radiographs; those differences need to be understood when planning pelvic procedures. Due to the systematic approach, this study gives insight into how morphological parameters need to be adjusted (degree changes) for patients with physiological pelvic tilt. Pelvic tilt significantly impacts acetabular version, with a maximum difference of 14.75° at 0°-10°, which is the most common range for patients, underscoring the need for patient-specific assessment. In contrast, center-edge angle changes by maximum 3.25° at a 10° tilt, and coverage by 2.4°, often clinically insignificant. For other parameters, no change, or minimal change is observed, variations in these parameters are due to differences between patients rather than pelvic tilt. These findings emphasize the importance of considering measurement sensitivity to pelvic tilt and individual patient context in clinical decision-making. [ABSTRACT FROM AUTHOR]

Purpose: Sprint kinematics have been linked to hamstring injury and performance. This study aimed to examine if a specific 6-week multimodal intervention, combining lumbopelvic control and unning technique exercises, induced changes in pelvis and lower-limb kinematics at maximal speed and improved sprint performance. Methods: Healthy amateur athletes were assigned to a control or intervention group (IG). A sprint test with 3-dimensional kinematic measurements was performed before (PRE) and after (POST) 6 weeks of training. The IG program included 3 weekly sessions integrating coaching, strength and conditioning, and physical therapy approaches (eg, manual therapy, mobility, lumbopelvic control, strength and sprint "front-side mechanics"-oriented drills). Results: Analyses of variance showed no between-group differences at PRE. At POST, intragroup analyses showed PRE–POST differences for the pelvic (sagittal and frontal planes) and thigh kinematics and improved sprint performance (split times) for the IG only. Specifically, IG showed (1) a lower anterior pelvic tilt during the late swing phase, (2) greater pelvic obliquity on the free-leg side during the early swing phase, (3) higher vertical position of the front-leg knee, (4) an increase in thigh angular velocity and thigh retraction velocity, (5) lower between-knees distance at initial contact, and (6) a shorter ground contact duration. The intergroup analysis revealed disparate effects (possibly to very likely) in the most relevant variables investigated. Conclusion: The 6-week multimodal training program induced clear pelvic and lower-limb kinematic changes during maximal speed sprinting. These alterations may collectively be associated with reduced risk of muscle strain and were concomitant with significant sprint performance improvement. [ABSTRACT FROM AUTHOR]

Background: Early identification of people at risk for cognitive decline is an important step in delaying the occurrence of cognitive impairment. This study investigated whether multimodal signals assessed using electroencephalogram (EEG) and gait kinematic parameters could be used to identify individuals at risk of cognitive impairment. Methods: The survey was conducted at the Veterans Medical Research Institute in the Veterans Health Service Medical Center. A total of 220 individuals volunteered for this study and provided informed consent at enrollment. A cap-type wireless EEG device was used for EEG recording, with a linked-ear references based on a standard international 10/20 system. Three-dimensional motion capture equipment was used to collect kinematic gait parameters. Mild cognitive impairment (MCI) was evaluated by Seoul Neuropsychological Screening Battery-Core (SNSB-C). Results: The mean age of the study participants was 73.5 years, and 54.7% were male. We found that specific EEG and gait parameters were significantly associated with cognitive status. Individuals with decreases in high-frequency EEG activity in high beta (25-30 Hz) and gamma (30-40 Hz) bands increased the odds ratio of MCI. There was an association between the pelvic obliquity angle and cognitive status, assessed by MCI or SNSB-C scores. Results from the ROC analysis revealed that multimodal signals combining high beta or gamma and pelvic obliquity improved the ability to discriminate MCI individuals from normal controls. Conclusion: These findings support prior work on the association between cognitive status and EEG or gait, and offer new insights into the applicability of multimodal signals to distinguish cognitive impairment. [ABSTRACT FROM AUTHOR]

Background: The anterior pelvic tilt is characterized by ASIS rotating inferiorly in relation to the PSIS or being positioned lower than the PSIS in the sagittal plane. When compared to non-athletes, football players are more likely to have a higher anterior pelvic tilt angle. The anterior pelvic tilt experienced by football players may make them more prone to musculoskeletal problems. Purpose: This study is intended to compare the effects of Swiss ball and McKenzie exercise on a sample of football players who have an anterior pelvic tilt without any symptoms. Materials and Methods: 30 Subjects who were selected in the stadium under Shai physio clinic based on inclusion criteria. They were divided equally among two groups. Group A (n=15) subjects were managed with Swiss Ball exercise and Group B (n= 15) subjects were managed with McKenzie exercise. The subjects were evaluated using Angulus ROM software. Study period: October 2022 to June 2023. Results: In Group A (Swiss Ball), the post-test mean value was 10.80 (2.27), significantly lower compared with Group B (Mckenzie Exercise), 16.33 (3.04). This demonstrates the correction of excessive anterior tilt among football players in Group-A following Swiss Ball Therapy. However, the subjects in both groups were found to have a significantly decreased anterior tilting of the pelvis now exists following the interventions in Group A (Swiss Ball) and Group B (Mckenzie Exercise). Conclusion: According to the present study's findings, participants with anterior pelvic tilt responded well to both the interventions. Nonetheless the subjects who used a Swiss ball exercise were found to have correction in anterior pelvic tilt more quickly than those who performed the McKenzie exercise. [ABSTRACT FROM AUTHOR]

Leg-length discrepancy (LLD) is a common condition that may cause posture changes and clinical consequences. Rasterstereography is a valid and reliable method that analyzes posture without radiation exposure and invasive procedures. This study aimed to assess the immediate effect of artificial LLD on pelvic position and spinal posture in athletes. Twenty-four elite karate athletes (14 men, 10 women) were included in the study. Sagittal imbalance, coronal imbalance, pelvic obliquity, pelvic torsion angle, thoracic kyphosis angle and lumbar lordosis angle were measured at different artificial LLD heights (5 –10 –15 –20 mm). Statistical analysis was performed with One-Way ANOVA with repeated measures or Friedman test. In cases where there were significant differences, pairwise comparisons were performed with least significant differences (LSD) test or Wilcoxon signed rank test. There were statistically significant differences in pelvic obliquity (p = 0.001), pelvic torsion (p = 0.001) and lumbar lordosis (p = 0.001) with varying LLD. However, there was no significant difference in sagittal imbalance, coronal imbalance and thoracic kyphosis angle. It has been observed that even a 5-mm LLD causes pelvic position and spinal posture changes. Future studies detecting these changes in populations with LLD via rastersterography may prevent possible musculoskeletal disorders. [ABSTRACT FROM AUTHOR]

To compare the effects of backward (BW) and forward (FW) walking training on back geometry and mobility function in children with hemiparetic cerebral palsy (CP). Fifty-five children with hemiparetic CP participated in this study. They were randomly assigned into two groups. For 12 weeks, both groups got a conventional physical therapy program three days/week. Groups A and B got a specifically developed FW walking training (25 minutes/session) and a specially designed BW walking training (25 minutes/session), respectively. The trunk imbalance, lateral deviation, pelvic tilting, pelvic torsion, surface motion, and dynamic gait index of group B improved significantly more than group A (p <.05). Both groups showed significant improvements in all measured variables (p <.05). BW walking training might be considered as an effective therapy modality for improving back geometry and mobility function in hemiparetic CP children compared with FW walking training combined with a typical program. [ABSTRACT FROM AUTHOR]

BACKGROUND: Dynamic knee valgus (DKV) during dynamic activity is associated with patellofemoral pain, one of the most common sports disorders, especially in females. No studies have examined the factors that can lead to DKV in females as compared to males while addressing the influence of factors on each other. OBJECTIVE: To identify factors of pelvis and lower joints kinematics affecting DKV during single-leg squat (SLS) in females compared to males with multiple regression analysis. METHODS: Forty-four healthy young people (24 females, 20 males) performed SLS, and pelvis, hip, knee, and ankle 3D kinematics were recorded. The 2D knee frontal plane projection angle (FPPA) was adopted as the DKV measurement. Multiple regression analysis was performed to determine the relationship between FPPA and the kinematics of each joint and segment. RESULTS: Hip adduction and pelvic contralateral rotation were explanatory factors for FPPA in females. Hip adduction, hip internal rotation, and knee external rotation were explanatory factors in males. CONCLUSIONS: The lower limb or pelvic motion factors affecting DKV during SLS differ between the sexes, with pelvic contralateral rotation being extracted only in women, possibly due to differences in pelvic width. [ABSTRACT FROM AUTHOR]

How much do active pelvic movements on a Swiss ball during labour affect maternal and neonatal outcomes? A randomised trial with concealed allocation, blinded assessors and intention-to-treat analysis. Two-hundred parturient women. The experimental group performed pelvic anteversion and retroversion, lateral pelvic tilts and circular hip movements according to individual obstetric evaluation (foetal station and position, cervical dilatation and the presence of early pushing urge) on a Swiss ball. The control group received usual care. Both groups were permitted to walk and shower. The primary outcome was the duration of the first stage of labour. The secondary outcomes were the duration of the second stage of labour, pain intensity, delivery mode, medication use, local swelling, fatigue, anxiety, satisfaction and neonatal outcomes. The experimental intervention reduced the duration of labour by 179 minutes (95% CI 146 to 213) in stage one and 19 minutes (95% CI 13 to 25) in stage two. It decreased pain by approximately 2 points (95% CI 2 to 2) on a 0-to-10 scale at 30, 60 and 90 minutes. It reduced the risk of a caesarean section (ARR 0.14, 95% CI 0.03 to 0.25; NNT 7, 95% CI 4 to 32) and vulvar swelling (ARR 0.11, 95% CI 0.03 to 0.19; NNT 9, 95% CI 5 to 31). It reduced fatigue by 18 points (95% CI 16 to 21) on a 15-to-75-point scale and anxiety by 9 points (95% CI 8 to 11) on an 18-to-72-point scale. Other effects were negligible or unclear. Active pelvic movements on a Swiss ball during labour reduced the duration of labour, pain intensity, and maternal fatigue and anxiety; they also lowered the risk of caesarean section and vulvar swelling. Several effects exceeded the smallest worthwhile effect. NCT04124835. [ABSTRACT FROM AUTHOR]

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Purpose: We aimed to investigate the relationship between spinopelvic imbalances and functional disabilities after total hip arthroplasty in an at least two years of follow-up. Methods: Patients with normal sagittal alignment and normal motion (PI-LL < 10°, APP < 13°, ∆SS > 10°) were defined as control, and patients with any of sagittal alignment or motion abnormalities were defined as case groups. Visual Analog Scale, SF-36, Harris hip score, HOOS-JR, and complications were recorded. Results: The differences of the means of Harris hip score, HOOS-JR, SF-36, and VAS score in the control and case groups were statistically significant. The mean of these parameters in patients with sagittal balanced (PI-LL < 10°) was much better than patients with sagittal unbalanced (PI-LL > 10°). Same results were noted in patients with decreased (∆SS < 10°) and normal spinopelvic motions (∆SS > 10°). Conclusion: Our observations indicate that spinopelvic imbalances are associated with worse postoperative functional outcomes in patients undergoing total hip arthroplasty. [ABSTRACT FROM AUTHOR]

Purpose This study aimed to clarify the relationship between foot and postural changes and low back pain during preg- nancy. Methods The study consisted of a questionnaire about low back pain during pregnancy and measurement surveys. The first survey was conducted at 14--16 weeks of gestation, the second at 24--26 weeks, and the third at 34--36 weeks. The participants were 14 pregnant women. We attached a spherical marker to the anterior superior iliac spine and posterior superior iliac spine. Using a digital camera, we photographed their standing postures from the sagittal plane and calculated the pelvic tilt angle. We applied a free curve ruler to measure the spinal curve, which was then traced on paper to calculate the thoracic kyphosis and lumbar lordosis angles. Participants were asked to adopt a natural standing posture barefoot on the flat glass plate of the pedoscope, and the state of the plantar surface touching the ground was photographed using a digital camera. The lower end of the navicular tuberosity was marked in the standing position, after which we measured the foot length and navicular height, divided the navicular height by the foot length, and multiplied by 100 to calculate the arch height. Statistical analysis was performed for each measurement item and a value of less than 5% was set as the significance level. Results The participants were nine primiparous women and five multiparous women, and 10 women developed low back pain during pregnancy; there was a tendency for the pelvis to tilt forward, the foot arch to flatten, and lordosis of the lumbar spine changed from decreased to increased as the pregnancy progressed, but the differences were not sig- nificant. The left ground contact plantar surface area ratio decreased significantly over time, and the ground contact area decreased as the pregnancy progressed (p<0.01). There were no significant differences over time in the pelvic tilt, thoracic kyphosis, and lumbar lordosis angles, arch height ratios, and ground contact plantar surface area ratios between those with and without low back pain during pregnancy, and between childbirth experiences. Conclusions Pregnant women tended to exhibit an increased pelvic tilt angle and decreased lumbar lordosis from the first to the second trimester of gestation, and increased values from the third trimester. Although the foot tended to flatten owing to the increasing load of the uterus, the ground contact area of the foot did not necessarily increase, and the toes were considered in a floating state because of the weight support by the heel. The anatomical characteristics of the uterus showed that pregnant women were more likely to bear weight on the right side during the third trimester of gestation. The onset of low back pain during pregnancy was associated with multiparous women, flattening of the foot arch, and lumbar spine alignment, which addressed the protrusion of the abdomen associated with uterine enlarge- ment. [ABSTRACT FROM AUTHOR]

Obtaining a proper position for total hip arthroplasty components is a crucial aspect of implant performance and consequently of patient outcomes. Restoring the original hip center and maintaining the limb length are key factors in reaching the optimal implant positioning. The aim of this study was to assess the accuracy and safety of a computed dynamic analysis system that, through patient-specific guides, tries to improve implant positioning and functional orientation according to patients' spinopelvic mobility and anatomy. A total of 100 consecutive patients were prospectively enrolled. All patients received an Optimized Positioning System dynamic hip preoperative planning schedule. A CT scan protocol follow-up analysis was performed 6 months after surgery. The mean deviations from the planned acetabular inclination and anteversion were 4.3° and 3.8°, respectively. In total, 98% of cases were within ± 10° of the Lewinnek safe zone, both for inclination and anteversion. The height of osteotomy deviated, on average, 1.6 mm. In total, 100% of cases were included within 4 mm of osteotomy. Patient-specific and laser-guided instrumentation was found to be safe and accurately reproduced dynamic planning in terms of the component orientation, osteotomy level, leg length and offset. [ABSTRACT FROM AUTHOR]

Background: Unintended pelvic positional change is an acknowledged intra-operative problem for hip arthroplasty, seen commonly with procedures performed in the lateral position. If unrecognised, such changes can dramatically alter final acetabular component anteversion potentially resulting in suboptimal construct performance. It has previously been suggested that pelvic roll of just 13° may be enough to place an otherwise perfectly orientated cup outside of conventional ± 10° safe zones. Using the real-time tracking capacity of a commercially available optical navigation system, we aimed to accurately quantify pelvic roll occurring during total hip arthroplasties (THAs) performed in the decubitus position. Methods: Prospectively collected data for 107 consecutive, unilateral, THAs were interrogated to determine the magnitude of pelvic movement around a central longitudinal axis (i.e. AP roll). Correlation statistics with patient age and body mass index (BMI) were also calculated. Results: A mean pelvic roll of 9.5° was observed, being anterior in 96% of cases. Of these, 18.3% of hips had a magnitude of roll greater than 13°. There were no statistically significant independent correlations observed between age (p = 0.87) or BMI (p = 0.59) and mean roll. Conclusions: Errors in achieving acetabular target version may result in numerous post-operative concerns including instability/dislocation, bearing wear, squeaking, range-of-movement limitation and increased revision rate. In a general cohort, our findings suggest a mean anterior pelvic roll during THA of nearly 10°. Without purposeful correction, this may cause substantial deviation from intended target positions. Future work is indicated to map changing pelvic roll during THA which is likely to follow a nonlinear trajectory. Level of evidence: IV.. [ABSTRACT FROM AUTHOR]

Static assessment and grouping of riders by competition level are prevalent in equestrian coaching practice and research. This study explored sagittal pelvic tilt in 35 competitive dressage riders to analyse the relationship between static and dynamic postures and assess the interaction of competition level. Riders were assessed using optical motion capture on a riding simulator at halt and in walk, trot, and left and right canter. Mean, minimum and maximum pelvic tilt, and range of motion (ROM) were measured as the pitch rotation of a rigid body formed by markers placed on the rider's left/right anterior and posterior superior iliac spines and sacrum, averaged over six time-normalised strides. Three key results emerged: (1) there are correlations between the rider's mean pelvic tilt in simulated walk, trot and canter, but not at halt; (2) mean pelvic tilt values are not significantly influenced by competition level (p = 0.233); and (3) the minimum and maximum pelvic tilt values illustrate individual strategies between gaits. Therefore, results from static assessment and grouping of riders by competition level should be interpreted with caution. Riders should be assessed as individuals, during dynamic riding-specific tasks, to understand their postural strategies. [ABSTRACT FROM AUTHOR]

The pelvic floor muscle (PFM) plays a role not only in lumbopelvic stabilization, but also in incontinence and sexual function. This study aimed to determine the effectiveness of PFM training by electrical stimulation (ES) on urinary incontinence, PFM performance (i.e. strength and power), lumbopelvic control, and abdominal muscle thickness in women with stress urinary incontinence (SUI). Participants were randomized into ES and control groups. The ES group underwent PFM ES for 8 weeks, whereas the control group underwent only a walking program. The impact of urinary incontinence on quality of life was assessed by the Incontinence Impact Questionnaire (IIQ)-7. PFM strength and power were measured using a perineometer. Lumbopelvic control was measured by one and double-leg-lowering tests. Abdominal muscle thickness was measured by sonography. The ES group showed significantly improved IIQ-7 scores and PFM performance, and had significantly higher values in both one and double-leg lowering tests (p <.05) after 8 weeks of training, indicating significant improvement from pre-session values (p <.005). There were no significant between- or within-group differences at rest in abdominal muscle thickness. PFM ES could improve lumbopelvic control and PFM performance, and reduce subjective symptoms of urinary incontinence in women with SUI. [ABSTRACT FROM AUTHOR]

Sprint start performance is measured as the horizontal external power, the time-average rate of horizontal kinetic energy generation. Although joint powers have been examined, not all segment rotations on which positive powers are exerted necessarily contribute to forward propulsion; details regarding horizontal power remain unclear. Here we show the contributions of segment rotations to the forward and upward propulsion. We calculated the joint power exerted on each segment and the contributions from segment rotations to the normalised average horizontal and vertical external powers ( P ^ hori z ¯ and P ^ vert ¯ ) during the sprint start by 12 male sprinters. Over half P ^ hori z ¯ (55 ± 6%) is due to the front thigh rotation (0.30 ± 0.04), on which the hip and knee exert positive power. Pelvic rotation does not contribute to P ^ hori z ¯ (0.00 ± 0.01). This highlights the importance of the hip-extensors strength and the need for it accompanied by the lumbar-extensors strength cancelling out the hip-extensors action on the pelvis and promoting hip-extensor-induced thigh rotation. The front thigh rotation decreases P ^ vert ¯ (−0.08 ± 0.02). P ^ vert ¯ is primarily induced by rotations of the thorax (0.04 ± 0.01), lumbar region (0.06 ± 0.02), and pelvis (0.04 ± 0.01). Rotations of the lower-limb segments did not contribute to upward propulsion. Therefore, the front thigh induces downward movement, which is counterbalanced by the trunk segments. We bridge the gap in the current understanding from joint power to P ^ hori z ¯ . We present a case involving segments on which positive joint powers are exerted similarly but play different roles: forward or upward propulsion, thereby providing insights into directional control mechanisms in explosive initiation of motion. We examined the contributions of segment rotations to the normalised average horizontal and vertical external powers ( P ^ hori z ¯ , P ^ vert ¯ ): the sprint start performance and the parameter to assess upward propulsion. Over half the total P ^ hori z ¯ (55 ± 6%) is due to the front thigh rotation, while the front thigh rotation decreases P ^ vert ¯ , which was counterbalanced by rotations of the thorax, lumbar region, and pelvis. We bridge the gap in the current understanding from joint power to P ^ hori z ¯ and further present a case involving segments on which positive joint powers are exerted but play different roles: forward or upward propulsion. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pelvic-drop exercise (PD) is unilateral weight-bearing exercise that is frequently performed in rehabilitation sessions because its easy application can trigger moderate-to-high gluteus medius (Gmed) activity. Hip rotation has been applied to effectively facilitate Gmed activity during exercise. OBJECTIVE: To determine the effects of PD with three different hip rotations on Gmed, tensor fasciae latae (TFL), gluteus maximus (Gmax) activity, and Gmed:TFL activity ratio in patients with Gmed weakness. METHODS: Eighteen subjects with Gmed weakness participated. Subjects performed three different forms of PD with neutral hip, hip internal rotation, and hip external rotation position. Surface electromyography was performed to quantify the activity of Gmed, TFL, and Gmax. RESULTS: PD with hip internal rotation showed significantly greater Gmed activity than with neutral hip and hip external rotation (P = 0.005 and P = 0.007, respectively). TFL also showed significantly greater activity during PD with hip interna rotation than neutral hip (P = 0.002). There were no significant differences in Gmax activity (P = 0.095) and Gmed:TFL activity ratio (P = 0.254) among different forms of PD. CONCLUSIONS: PD with hip internal rotation is recommended to stimulate greater Gmed activity while preserving Gmed:TFL muscle activity ratio. [ABSTRACT FROM AUTHOR]

BACKGROUND: Recently there has been a rise in female participation in running yet the female population is under-researched in sport specific research. Locally, many female athletes annually compete in numerous ultra-marathons (> 42 km). OBJECTIVE: This study investigated the importance of Gluteal muscle strength in dynamic pelvic stability of fatigued female endurance road runners. METHODS: Fourteen female endurance runners (age: 38.0 ± 10.12 years, BMI: 21.99 ± 2.37 kg/m 2 , and VO 2max : 40 ± 5.34 ml/min/kg) volunteered for the participation of this study. Through isokinetic testing, muscle strength and fatigability of the Gluteus Maximus, Medius and Minimus was determined. Sign tests compared pelvis stability (unilateral Trendelenburg, Pelvic Bridge test and pelvic stability through a gait analysis) before and after an endurance run on a cambered and flat surface. Participants were divided into two groups based on change in pelvic stability after the fatigue intervention. RESULTS: The unaffected group was moderately younger; lighter in weight and had a lower BMI. Additionally, this group was largely more experienced (p = 0.61, d = 1.341); aerobically fit and ran significantly longer weekly distances (p = 0.002, d = 3.4). There was no statistical difference in isokinetic testing of strength and endurance hip flexion/extension and abduction/adduction between the two groups (p > 0.05). CONCLUSION: In conclusion, the group that was more experienced and ran longer weekly distances showed no change in pelvic stability after an endurance run. However, the group that showed changes in pelvic stability suggests that fatigue could be a contributing factor to pelvic compensation. It is recommended that female endurance runners incorporate strength training to strengthen the Gluteal and Hip Flexor muscle groups to reduce pelvic compensation. [ABSTRACT FROM AUTHOR]

Background Lower neurocognitive function is a risk factor for anterior cruciate ligament (ACL) injury. However, the mechanism by which lower neurocognitive function increases the risk of ACL injury remains unclear. Purpose To clarify the effect of differences in neurocognitive function on landing mechanics during a single-leg drop-jump landing motion followed by an unanticipated task. Study Design Cross-sectional study Methods Fifteen collegiate female athletes were recruited (20.1 ± 1.3 years, 166.6 ± 7.3 cm, 60.6 ± 6.9 kg) and were divided into two groups (the high-performance (HP) group and the lower-performance (LP) group) using the median Symbol Digit Modalities Test (SDMT) score. Three-dimensional motion analysis was employed for the analysis during the experimental task of a single-leg drop-jump followed by an unanticipated landing task from a 30-cm high box. Joint angular changes of the trunk, pelvis, hip, and knee were calculated within the interval from initial contact (IC) to 40ms. Knee and hip moments were calculated as the maximum values within the interval from IC to 40ms. Surface electromyography data from key muscles were analyzed 50ms before and after IC. Independent t-tests were used to compare the effects of different neurocognitive function on the measurement items. Statistical significance was set at p < 0.05. Results The SDMT score was significantly higher in HP group (HP: 77.9 ± 5.5; LP: 66.0 ± 3.4; p < 0.001). The LP group had a significantly greater trunk rotation angular change to the stance leg side (HP: 0.4 ± 0.8; LP: 1.2 ± 0.4; p = 0.020). There were no significant differences between the two groups in terms of joint moments, and muscle activities. Conclusion Differences in neurocognitive function by SDMT were found to be related to differences in motor strategies of the trunk in the horizontal plane. Although trunk motion in the sagittal and frontal planes during single-leg drop-jump landing increases the ACL injury risk by affecting knee joint motion, the effect of trunk motion in the horizontal plane remains unclear. [ABSTRACT FROM AUTHOR]

In a running single-leg jump (RSLJ) for distance, the generation of vertical velocity without loss of horizontal velocity during the take-off phase is ideal, but difficult; however, we hypothesized that the pelvic rotation in the frontal plane achieved it. Here we show the effect of each segment rotation on the horizontal and vertical kinetic energies ( E h o r i z and E v e r t ) of the centre of mass (CoM) during the take-off phase of an RSLJ for distance. We collected kinematic and ground-reaction-force data during RSLJs for distance by nine male long jumpers, involving an approximately 20-m approach in an outdoor field. We determined the components of the E h o r i z and E v e r t changes due to each segment movement. Elevation of the pelvic free-leg side increased E v e r t (0.53±0.16 J/kg, 9±3% of the total E v e r t change). Pelvic axial rotation decreased E h o r i z , while pelvic elevation did not affect it (0.01±0.02 J/kg, no significant difference from zero). In contrast, forward rotations of the stance-leg shank and thigh decreased E h o r i z while simultaneously increasing E v e r t . The results showed that pelvic elevation increased the vertical CoM velocity without causing a loss in horizontal velocity, although the lower-limb segments' effects on the vertical and horizontal velocities exhibited a trade-off, as previously speculated. RSLJs for distance have been frequently assumed as sagittal movements. However, our findings highlight the importance of three-dimensional pelvic movement, particularly in the frontal plane, for controlling both the vertical and horizontal velocities. Highlights l We show the effect of each segment rotation on the horizontal and vertical kinetic energies ( E h o r i z and E v e r t ) of the centre of mass during the take-off phase of a running single-leg jump for distance. l Elevation of the pelvic free-leg side increased E v e r t but did not decrease E h o r i z , while the forward rotations of the stance-leg thigh and shank decreased E h o r i z , while simultaneously increasing E v e r t . l We highlight the importance of pelvic movement in the frontal plane for controlling both the vertical and horizontal velocities with single-leg stance. [ABSTRACT FROM AUTHOR]

Objectives: The baseball pitching motion is one of the most complex movements in sports and stresses the elbow joint with substantial amounts of force. Over the past two decades the incidence of elbow injury and the need for surgical intervention in baseball pitchers has been on the rise. This multifactorial problem has stimulated the implementation of pitch count limits, advising against early pitching specialization, and increased the focus on proper pitching biomechanics to improve injury prevention. A majority of pitching biomechanics research has focused on upper extremity kinematics, however research concerning the contribution of the lower extremities to the overall pitching motion requires further understanding. To minimize the risk of injury to the elbow while maximizing performance, a pitcher must be able to efficiently transfer energy through the lower extremities up through their throwing arm. Of particular interest in this paper is understanding the implications of stride position on pelvic rotation, elbow varus moment, and ball velocity. The purpose of this study was to investigate the affect of stride position and pelvic kinematics on the elbow varus moment and ball velocity in collegiate level pitchers. It was hypothesized that pitchers that land in a crossed-over stride position would reduce their ability to achieve maximum pelvic rotation range of motion, leading to an increase in elbow varus moment and decreasing fastball velocity. Methods: Pitchers were recruited from NCAA Division I and Division III college baseball teams and were included in this study if they were actively pitching for their collegiate team. Pitchers were excluded if they had experienced an injury that caused them to miss one game or practice within the preceding 6 months. Each participant pitched a total of seven of each pitch type they were comfortable throwing in a game setting from a regulation indoor mound towards a pitching target 60 feet 6 inches away. Data for this study were limited to fastball data only. Motion data were collected at 250Hz using a 12 camera Vicon 512 motion analysis system (Vicon, Oxford, UK). Kinematic data were calculated using a 16- segment biomechanical model based on Euler's equations of motion, and upper extremity joint kinetics were calculated using standard inverse dynamic techniques. Stride cross-over was defined as when the pitcher's lead stride foot landed more towards third base if they were a right-handed pitcher or more towards first base if they were a left-handed pitcher (Figure 1). Other predictor variables included pelvic angular velocity (°/sec), pelvic rotation at ball release (°), and pelvic range of motion (°). Statistical analyses were performed using a mixed effects random intercept regression model to determine associations among the variables of interest. Results: A total of 99 baseball pitchers were recruited with a mean age of (20.7 ± 1.3 years), height of (1.8 ± 0.7 m), and weight of (88.6 ± 13.5kg). No pitchers were excluded from this analysis. Regression analysis demonstrated that for every 100°/sec increase in pelvis angular velocity the elbow varus moment increased by 5.6Nm (p=0.00) and ball velocity increased by 0.43mph (p=0.00). Additionally, it was noted that for every 10° increase in pelvis rotation at ball release and 10° increase in total pelvic range of motion, the elbow varus moment increased by 0.4Nm and 0.2Nm respectively (p=0.036, p=0.02) and ball velocity increased by 1.8mph and 1.1mph respectively (p=0.03, p=0.01). Pitchers that achieved greater pelvis range of motion experienced a 0.26% increase in elbow varus moment accompanied by a 1.6% increase in ball velocity. Additionally, pitchers that demonstrated greater pelvis rotation at ball release experienced a 0.53% increase in elbow varus moment and 2.55% increase in ball velocity. Although not statistically significant a quartile analysis demonstrated that pitchers who landed in a cross-over stride position had the largest elbow varus moments accompanied by relatively low-ball velocity compared to pitchers that landed in an open stride position, who tended to have low elbow varus moments with relatively high ball velocity (Figure 2). Conclusions: The results of this study indicated that stride position during pitching was associated with both elbow varus moment and ball velocity. Pitchers that landed in a more crossed-over position experienced greater elbow varus moment and lower fastball velocity compared to those that landed in an open stride position. It is theorized that an open stance stride position allowed the pelvis to achieve full range of motion, thus leading to an efficient energy transfer to the throwing arm. This was supported by the finding that pitchers who achieved greater pelvic range of motion experienced smaller elbow varus moments compared to pitchers with less pelvic range of motion. Additionally, pitchers who demonstrated greater pelvic rotation at ball release and greater pelvic range of motion experienced an almost two mile per hour and one mile per hour increase in fastball velocity, respectively. These results can aid pitching coaches and trainers in understanding the implications of incorrect lower extremity pitching mechanics on elbow injury risk reduction and performance in baseball pitchers. [ABSTRACT FROM AUTHOR]

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Purpose: In total hip arthroplasty (THA), the functional anatomy of the spinopelvic unit should be taken into account to provide the correct functional positioning of the implant. The relationship between the spine and the pelvis in the sagittal plane is represented by pelvic tilt (PT). The sacral slope (SS) has been proposed as a more reliable parameter than the anterior pelvic plane (APP) to express the PT. This study investigated the relationship between the APP and the SS; and the relationship between the APP and the SS, respectively, with the postoperative acetabular orientation. Methods: 45 patients undergoing primary THA were prospectively enrolled. The EOS 2D/3D system was used to perform the radiographic evaluation before and 3 months after surgery. The following parameters were measured in both standing and sitting position: SS, APP, acetabular anteversion (AA) and inclination (AI). Results: The SS values did not show any correlation with the values of the APP angle. The changes of the SS in the transition from the standing to the sitting position significantly correlated with the changes of the AA (r = −0.61; p < 0.0001). A weak correlation was found between the APP angle and the AA in standing position (r = −0.35; p = 0.02). Conclusions: The SS accurately expresses the functional orientation of the pelvis in the sagittal plane, and the functional orientation of the cup after hip replacement. Therefore, SS could be taken into account by navigation systems in order to achieve a patient-specific functional position of the acetabular cup. [ABSTRACT FROM AUTHOR]

Background: This study aimed to quantitatively evaluate lateral center-edge angle (LCEA) and anterior center-edge angle (ACEA) according to sex and the anterior pelvic plane (APP) tilt angle and analyze the correlation between these measurements and acetabular coverage. Methods: Computed tomography scans of 71 adults (38 men and 33 women) with normal hip joints were obtained. LCEA, anterior ACEA, and acetabular coverage were measured with APP tilt every 5° from − 30° to + 30° and were compared between the sexes. The correlation between acetabular coverage and LCEA/ACEA was also analyzed. Results: (1) LCEA, ACEA, and acetabular coverage were statistically larger in men than in women at all APP tilt angles (with the exception of acetabular coverage ≥ 25°). (2) LCEA, ACEA, and acetabular coverage differed according to APP tilt angle. LCEA and acetabular coverage showed maximum values at 10°. ACEA showed a tendency to increase by an average of 3.6° for every 5° increase in the APP tilt angle. LCEA demonstrated strong and very strong associations across all APP tilting angles, whereas ACEA showed a moderate association at angles ≥ 15° in men and ≥ 30° in women. Conclusions: The LCEA and ACEA are adequate measurement methods that reflect actual acetabular coverage unless the pelvis is tilted excessively anteriorly. While pelvic tilting does not need to be considered for LCEA within the physiologic range, it should always be taken into account for ACEA, as it increases by an average of 3.6° for every 5° increase in APP tilt angle. Level of evidence: Level III: retrospective cohort study. [ABSTRACT FROM AUTHOR]

Background: Although it is important to consider pelvic alignment and mobility in the standing and sitting positions before THA, it is not known how to preoperatively predict individual postoperative pelvic alignment and mobility. The purpose of this study was to investigate the pelvic alignment and mobility before and after THA, and to develop a predictive formula using preoperative factors to calculate postoperative sagittal alignment and mobility. Methods: One hundred seventy patients were assessed. The 170 patients were randomly divided into a prediction model analysis group (n = 85) and an external validation group (n = 85). In the prediction model analysis group, preoperative spinopelvic parameters were used to develop the predictive formulas to predict the postoperative sacral slope (SS) in standing and sitting positions and ΔSS. These were applied to the external validation group and assessed. Results: R2 in multiple linear regression models for postoperative SS in standing, SS in sitting and ΔSS were 0.810, 0.672, and 0.423, respectively. The values of predicted and postoperative parameters were very close with no significant difference: SS in standing (33.87 vs. 34.23, P = 0.834), SS in sitting (18.86 vs. 19.51, P = 0.228), and ΔSS (15.38 vs. 14.72, P = 0.619). Conclusion: The present study showed that the pelvic alignment and mobility after THA can be predicted using preoperative factors. Although a model with higher accuracy is needed, it is important to use a predictive formula to estimate the postoperative condition before performing THA. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the influence of technical and core stability parameters on rowing ergometer performance defined as mean power at the handle. Twenty-four high-level rowers were evaluated at their competitive stroke rate on an instrumented RowPerfect 3 ergometer to determine leg, trunk and arm power output, while trunk and pelvis 3D kinematics were measured. Linear mixed models revealed that mean power at the handle was predicted by the power output of legs, trunk and arms (r2 = 0.99), with trunk power being the best predictor. Time to peak power, work ratio and mean to peak power ratio were relevant technical parameters significantly predicting the different segments' power. In addition, a greater trunk range of motion significantly influenced the power produced by this segment. Accordingly, achieving an earlier peak power together with enhanced work production at the trunk and arm levels, as well as distributing the segments power over the whole drive phase, could serve as recommendations for technical training of rowers on dynamic ergometers in order to produce higher power output. Furthermore, the trunk appears to play a major role as a power producer within the kinetic chain from the legs to the arms. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the impact of pelvis rotation velocity, trunk rotation velocity, and hip-shoulder separation on ball velocity during baseball pitching. Fastball pitching kinematics were recorded in 29 male pitchers (age 17 ± 2 years, 23 high school, 6 college). Pelvis and trunk angular velocities and hip-shoulder separation were calculated and averaged for the 3 fastest pitches. Associations between peak pelvis velocity, peak trunk velocity, hip-shoulder separation at foot contact, and ball velocity were assessed using Pearson correlation coefficients and multiple regression. The average ball velocity was 33.5 ± 2.8 m·s-1. The average hip-shoulder separation at foot contact was 50 ± 12°. The peak pelvis velocity (596 ± 88°·s-1) occurred at 12 ± 11% of the time from stride foot contact to ball release, with the peak trunk velocity (959 ± 120°·s-1) occurring at 36 ± 11%. Peak trunk velocity was predictive of ball velocity (p = 0.002), with 25% of the variability in ball velocity explained. No combination of factors further explained ball velocity. Hip-shoulder separation at foot contact (17%, p = 0.027), peak pelvis velocity (23%, p = 0.008), and the timing of peak pelvis velocity (16%, p = 0.031) individually predicted peak trunk velocity. The combination of peak pelvis velocity, hip-shoulder separation at foot contact, and the timing of peak trunk velocity explained 55% of the variability in trunk rotation velocity (p < 0.001). These data highlight the importance of interactions between pelvis and trunk for maximizing velocity in pitching. Training to improve pelvis-trunk axial dissociation may increase maximal trunk rotation velocity and thereby increase ball velocity without increasing training load on the shoulder and elbow. [ABSTRACT FROM AUTHOR]