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Objective: This study aimed to investigate the association between muscle density as an indicator of fatty infiltration of lower extremity muscles and physical activity (PA) after total hip arthroplasty (THA) and identify the patient characteristics with high postoperative PA. Methods: This study included 62 female patients who underwent THA for unilateral hip osteoarthritis. Muscle density of the gluteus maximus, gluteus medius, iliopsoas, and quadriceps muscles was measured using computed tomography (CT). PA was assessed using University of California, Los Angeles (UCLA) activity scores. CT and UCLA activity score were obtained before and 1 year after THA. The patients were divided into two groups, sufficient (score ≥ 6) and insufficient (score < 6) activity groups, based on their level of PA as determined by their UCLA activity score 1 year after THA. The association of PA with the amount of changes in muscle density was examined with Spearman's rank correlation coefficient. Logistic regression analysis was performed to identify postoperative factors determining PA at 1 year after THA. Results: Spearman's rank correlation coefficient showed a significantly positive association between recovery in PA and an increase in muscle density of the gluteus maximus, gluteus medius, iliopsoas, and quadriceps muscles. Additionally, logistic regression analysis confirmed that postoperative muscle densities of the gluteus maximus and quadriceps muscles were variables determining the PA 1 year after THA. Conclusion: The findings of this study indicated that the improvement of fatty infiltration in lower limb muscles, especially in the gluteus maximus and quadriceps, is likely to promote the increase in postoperative PA. [ABSTRACT FROM AUTHOR]

Background: Human locomotion involves the coordinated activation of a finite set of modules, known as muscle synergy, which represent the motor control strategy of the central nervous system. However, most prior studies have focused on isolated muscle activation, overlooking the modular organization of motor behavior. Therefore, to enhance comprehension of muscle coordination dynamics during multi-joint movements in chronic ankle instability (CAI), exploring muscle synergies during landing in CAI patients is imperative. Methods: A total of 22 patients with unilateral CAI and 22 healthy participants were recruited for this research. We employed a recursive model for second-order differential equations to process electromyographic (EMG) data after filtering preprocessing, generating the muscle activation matrix, which was subsequently inputted into the non-negative matrix factorization model for extraction of the muscle synergy. Muscle synergies were classified utilizing the K-means clustering algorithm and Pearson correlation coefficients. Statistical parameter mapping (SPM) was employed for temporal modular parameter analyses. Results: Four muscle synergies were identified in both the CAI and healthy groups. In Synergy 1, only the gluteus maximus showed significantly higher relative weight in CAI compared to healthy controls (p = 0.0035). Synergy 2 showed significantly higher relative weights for the vastus lateralis in the healthy group compared to CAI (p = 0.018), while in Synergy 4, CAI demonstrated significantly higher relative weights of the vastus lateralis compared to healthy controls (p = 0.030). Furthermore, in Synergy 2, the CAI group exhibited higher weights of the tibialis anterior compared to the healthy group (p = 0.042). Conclusions: The study suggested that patients with CAI exhibit a comparable modular organizational framework to the healthy group. Investigation of amplitude adjustments within the synergy spatial module shed light on the adaptive strategies employed by the tibialis anterior and gluteus maximus muscles to optimize control strategies during landing in patients with CAI. Variances in the muscle-specific weights of the vastus lateralis across movement modules reveal novel biomechanical adaptations in CAI, offering valuable insights for refining rehabilitation protocols. [ABSTRACT FROM AUTHOR]

Background Verbal and tactile cues can increase muscle activity, force production, and kinematics. Several studies demonstrate the effects of verbal and tactile cues on upper extremity muscles, while relatively few examined lower extremity muscles, specifically the gluteals. Studies that observed changes in gluteal function from verbal and tactile cues examined muscle activity via electromyography rather than force production or functional activities such as jumping. Purpose The purpose of this study was to measure the effects of verbal and tactile cues on gluteal force production and broad jump distance. Study Design Cross-Sectional cohort Methods Gluteus maximus force production and broad jump distance were tested in forty-two healthy male and female university students at baseline and after verbal and tactile cues given in random order. Gluteus maximus force was measured using handheld dynamometry and reported in kilograms. Verbal cues included "push, push, push" before both tests. The examiner provided tactile cues to the gluteus maximus before force production testing, and the participant provided tactile cues to both gluteus maximus muscles before performing the broad jump. Performance on the broad jump was measured in centimeters. Descriptive statistics and test-retest reliability via Pearson correlation coefficients were calculated, differences in performance between sexes were analyzed with an independent t-test, and changes in force production and jump distance from baseline were analyzed using a one-way ANOVA. Results Mean gluteus maximus force production following verbal cues significantly increased (p = 0.000) by 13.48% (3.83 kg) compared to the control condition, while gluteal force production following the tactile cues was not significantly different. Broad jump distance following the verbal cues significantly increased (p = 0.000) 3.99% (7.71 cm) compared to the control condition and significantly increased (p = 0.000) by 2.95% (5.71 cm) following the tactile cues. There were no significant differences in performances between males and females. The test-retest reliability of all measurements was 0.97-0.99. Conclusion Verbal cues significantly increased gluteus maximus force production and broad jump distance. Tactile cues significantly increased broad jump distance but had no significant effect on gluteus maximus force. These results have implications for clinical testing and athletic performance when gluteus maximus force and jump distance are concerned. Level of Evidence 3 [ABSTRACT FROM AUTHOR]

Emerging evidence indicates a complex interplay between skeletal muscle and cognitive function. Despite the known differences between muscle quantity and quality, which can be measured via computed tomography (CT), the precise nature of their associations with cognitive performance remain underexplored. To investigate the links between muscle size and density and cognitive impairment (CI) in the older adults with hip fractures, we conducted a post hoc, cross-sectional analysis within a prospective cohort study on 679 patients with hip fractures over 65. Mini-Mental State Examination (MMSE) and routine hip CT imaging were utilized to assess cognition function and muscle characteristics in older adults with hip fractures. The CT scans provided data on cross-sectional area and attenuation for the gluteus maximus (G.MaxM) and the combined gluteus medius and minimus (G.Med/MinM). Participants were categorized into CI and non-CI groups based on education levels and MMSE scores. Multivariate logistic regressions, propensity score (PS) methods, and subgroup analysis were employed to analyze associations and validate findings. This study included 123 participants (81.6 ± 6.8 years, 74% female) with CI and 556 participants (78.5 ± 7.7 years, 72% female) without. Compared to the non-CI group, muscle parameters, especially density, were significantly lower in the CI group. Specifically, G.Med/Min muscle density, but not size was robustly associated with CI (odds ratio (OR) = 0.77, 95% confidence interval = 0.62–0.96, P  = 0.02), independent of other medical situations. Sensitivity analysis corroborated that G.Med/Min muscle density was consistently lower in the CI group than the non-CI group, as evidenced in the PS matched (P  = 0.024) and weighted cohort (P  = 0.033). Enhanced muscle parameters, particularly muscle density in the G.Med/MinM muscle, correlate with a lower risk of CI. Muscle density demonstrates a stronger association with cognitive performance than muscle size, highlighting its potential as a key focus in future cognitive health research. [ABSTRACT FROM AUTHOR]

The efficacy of interrupting prolonged sitting may be influenced by muscle activity patterns. This study examined the effects of interrupting prolonged sitting time with different muscle activity patterns on continuously monitored postprandial glycemic response. Eighteen overweight and obese men (21.0 ± 1.2 years; 28.8 ± 2.2 kg/m2) participated in this randomized four‐arm crossover study, including uninterrupted sitting for 8.5 h (SIT) and interruptions in sitting with matched energy expenditure and duration but varying muscle activity: 30‐min walking at 4 km/h (ONE), sitting with 3‐min walking at 4 km/h (WALK) or squatting (SQUAT) every 45 min for 10 times. Net incremental area under the curve (netiAUC) for glucose was compared between conditions. Quadriceps, hamstring, and gluteal muscles electromyogram (EMG) patterns including averaged muscle EMG amplitude (aEMG) and EMG activity duration were used to predict the effects on glucose netiAUC. Compared with SIT (10.2 mmol/L/h [95%CI 6.3 to 11.7]), glucose netiAUC was lower during sitting interrupted with any countermeasure (ONE 9.2 mmol/L/h [8.0 to 10.4], WALK 7.9 mmol/L/h [6.4 to 9.3], and SQUAT 7.9 mmol/L/h [6.4 to 9.3], all p < 0.05). Furthermore, WALK and SQUAT resulted in a lower glucose netiAUC compared with ONE (both p < 0.05). Only increased aEMG in quadriceps (−0.383 mmol/L/h [−0.581 to −0.184], p < 0.001) and gluteal muscles (−0.322 mmol/L/h [−0.593 to −0.051], p = 0.022) was associated with a reduction in postprandial glycemic response. Collectively, short, frequent walking or squatting breaks effectively enhance glycemic control in overweight and obese men compared to a single bout of walking within prolonged sitting. These superior benefits seem to be associated with increased muscle activity intensity in the targeted muscle groups during frequent transitions from sitting to activity. [ABSTRACT FROM AUTHOR]

Background: There are deficiencies in ensuring the permanence of some theoretical information taught in nursing education and transferring it to practice environment. Mobile‐assisted teaching can be useful to eliminate deficiencies. The aim of this study was to determine the effect of mobile‐assisted teaching on nursing students' learning ventrogluteal injection. Methodology: The study was conducted in Turkey between February and June 2022. This study is a single group pre‐posttest intervention. The study sample consisted of 354 students studying in the 2nd, 3rd and 4th grades in Turkey. After the students completed the Introductory Characteristics Form and Ventrogluteal Region Information Suggestion Form in the pre‐test, the researchers sent a ventrogluteal injection animation video to their mobile phones. The students who watched the video completed the Ventrogluteal Region Information Suggestion Form and Mobile Education Activity Form in the final test. Results and Conclusion: There was a statistically significant difference between the pre‐posttest score medians of the students (p < 0.001). While the preference of the students for the ventrogluteal region in intramuscular injection was 28.5% before mobile learning, it increased to 51.1% after the training. In this study, after the training given through mobile learning, the knowledge level of the students about ventrogluteal injection and their preferences for ventrogluteal injection increased. In line with these results, mobile‐assisted education should be used in nursing education. Lay Description: What is already known about this topicDue to the high number of students per teaching staff in Turkey, it takes time for the theoretical education of the students to turn into practice.It is recommended that students prefer and use the ventrogluteal (VG) region for intramuscular drug injection.The students had difficulties because the nurses guiding them in clinical practice did not use the VG area.There are difficulties in applying the VG region injection in practice. What this paper addsMobile‐based intramuscular injection skill application increased the knowledge level of the students.Mobile applications make it easier to remember the learned information and apply it in the clinic. Implications for practice and/or policyMobile applications demonstrating skill practice provide a resource for nursing students to watch and learn whenever they want.It ensures that the student is always ready for invasive procedures to be performed on the patient in the clinic. [ABSTRACT FROM AUTHOR]

Running has become 1 of the 2 most well-known exercises for health; however, running may cause injuries. The purpose of this analytical descriptive study was to examine the occurrence of pelvic drop during moderate-intensity running in female novice and recreational runners; as well as investigating the relationship between the change in pelvic alignment and Rating of Perceived Exertion (RPE), Rating of Perceived Exertion for Legs (RPElegs) and Gluteus muscles fatigue in novice and recreational runners. The participants, aged between 18 and 35 years old, comprised 27 novice runners (less than 1 year of running experience) and 27 recreational runners (2 - 4 years running experience). The participants in both groups performed the maximal oxygen uptake (VO2max) test and ran at a self-selected speed on a treadmill for 30 min at moderate-intensity within the specified heart rate range of 40 - 59 % heart rate reserve (HRR). RPE, RPElegs and sEMG were collected every 2 min and the pelvic kinematic data were also recorded every minute during the 30 min treadmill running test. The data were analyzed with a statistical significance level at p-value < 0.05. The results demonstrated that the time in starting pelvic drop was 8.15 ± 5.07 and 18.37 ± 6.70 min in female novice and recreational runner groups, respectively (p < 0.01). Pearson's correlations showed relationship between the pelvic alignment and RPE in novice runners (r = 0.47, p < 0.01) and recreational runners (r = 0.39, p < 0.01). Besides, Pearson's correlations showed relationship between the pelvic alignment and RPElegs in novice runners (r = 0.48, p < 0.01) and recreational runners (r = 0.32, p < 0.01). In both groups, there was no relationship between the pelvic alignment and Gluteus medius and Gluteus maximus muscle fatigue. According to the study, the occurrence of a pelvic drop in novice runners was faster than recreational runners. The study indicated that consideration of RPE and RPElegs variables might be beneficial for female runners and future studies. [ABSTRACT FROM AUTHOR]

Purpose: This study investigates the effects of exercises on sand on the frequency content of the lower limb muscles in individuals with anterior cruciate ligament reconstruction and pronated feet during walking. Methods: This was a semi-experimental and laboratory-type study. The study samples included 28 male students with pronated feet and anterior... [ABSTRACT FROM AUTHOR]

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Posterior femoral cutaneous nerve (PFCN) entrapment due to overuse is rarely reported in the literature, and treatment is limited. Conventional treatment includes focused rehabilitation exercises, computed tomography--guided ormagnetic resonance (MR)--guided nerve blocks,MR-guided cryoablation, and surgical decompression, but data for treatment validation and efficacy are lacking. Sub-gluteus maximus fascial plane and perineural hydrodissection may offer an effective alternative treatment for PFCN entrapment, especially given reports of successful cases with similar procedural techniques in other anatomical locations and structures. [ABSTRACT FROM AUTHOR]

Purpose: To enhance performance in race riding, knowledge of current training workload is required. The objectives of this study were to quantify the physiological demands and profile the muscle activity of jockeys riding track-work. Methods: Ten apprentice jockeys and 48 horses were instrumented with heart-rate monitors, accelerometers, and a surface electromyography BodySuit (recording 8 muscle groups: quadriceps, hamstrings, gluteal, lower back, obliques, abdominal, trapezial, and pectoral) that recorded continuously while riding their normal morning track-work. Data were extracted and time matched into 200-m sections for analysis once the jockey reached steady-state canter (6.9 m·s−1). Results: Jockeys rode a mean (±SD) of 6 (1) horses each morning over 2.5 hours, spending ∼30 minutes at a canter (8.8 [ 0.7] m·s−1), with mean heart rate of 129 (11) beats·min–1 and ratings of perceived exertion representing easy-/moderate-intensity exercise. Mean magnitude of horse (0.17 [0.01] m) and jockey center of mass (0.16 [0.02] m) displacement per stride differed from that of the jockey's head (0.11 [0.01] m, P <.05). The majority of horse oscillation was damped in the upper body with a 3-fold reduction in the medio/lateral and fore/aft planes (P <.05), to minimize jockey head movement. Lower-body muscles absorbed horse motion, with core and upper-body muscles important for postural stabilization. Conclusions: The physiological demands of riding track-work were low, with no evidence of fatigue. Future research on jockeys in races as comparison would identify the specific requirements of a jockey-specific physical conditioning program. [ABSTRACT FROM AUTHOR]

Context: Lesser hip muscle strength is commonly observed in females with patellofemoral pain (PFP) compared with females without PFP and is associated with poor subjective function and single-leg squat (SLS) biomechanics. Hip muscle weakness is theorized to be related to PFP, suggesting centrally mediated muscle inhibition may influence the observed weakness. The central activation ratio (CAR) is a common metric used to quantify muscle inhibition via burst superimposition. However, gluteal inhibition has yet to be evaluated using this approach in females with PFP. The study objectives are to (1) describe gluteal activation in the context of subjective function, hip strength, and squatting biomechanics and (2) examine the relationship of gluteal activation with subjective function and squatting biomechanics in females with PFP. Design: Cross-sectional. Methods: Seven females with PFP (age = 22.8 [3.6] y; mass = 69.4 [18.0] kg; height =1.67 [0.05] m, duration of pain = 6-96 mo) completed this study. Subjective function was assessed with the Anterior Knee Pain Scale, while fear-avoidance beliefs were assessed with the Fear-Avoidance Belief Questionnaire physical activity and work subscales. Biomechanical function was assessed with peak hip and knee angles and moments in the sagittal and frontal planes during SLS. Gluteus medius (GMed) and gluteus maximus (GMax) activation were assessed with the CAR. Descriptive statistics were calculated, and relationships between variables were assessed with Spearman rho correlations. Results: The CAR of GMed and GMax was 90.5% (8.1 %) and 84.0% (6.3%), respectively. Lesser GMed CAR was strongly associated with greater hip adduction during SLS (p=-.775, P= .02) and greater fear-avoidance beliefs--physical activity subscale (p =-. 764, P= .018). Conclusion: We found a wide range in GMed and GMax activation across females with PFP. Lesser GMed activation was associated with greater hip adduction during SLS and fear of physical activity, suggesting that gluteal inhibition should be assessed in patients with PFP. [ABSTRACT FROM AUTHOR]

(1) Background: Pelvic-floor-muscle (PFM) activation acts synergistically with multiple muscles while performing functional actions in humans. The purpose of this study was to characterize the activity of the PFMs and gluteus medius (GM) while walking and running in physically active nulliparous females. (2) Methods: The peak and average amplitude of maximal voluntary contractions (MVCs) during 60 s of walking (5 and 7 km/h) and running (9 and 11 km/h) were measured with electromyography of the GM and PFMs in 10 healthy female runners. (3) Results: The activation of both muscles increased (p < 0.001) while walking and running. The MVC of the GM was reached when walking and tripled when running, while the PFMs were activated at half their MVC when running. The global ratio of the GM (75.3%) was predominant over that of the PFMs (24.6%) while static and walking. The ratio reached 9/1 (GM/PFM) while running. (4) Conclusion: The GM and PFMs were active while walking and running. The GM's MVC tripled at high speeds, while the PFMs reached only half of their maximum contraction. [ABSTRACT FROM AUTHOR]

Introduction: Chronic hip abductor insufficiency is a rare debilitating condition. In cases refractory to conservative treatment and not amenable to direct repair an augmentation becomes necessary. The preferred salvage method at our institution is augmentation with the anterior third of the gluteus maximus tendon. The aim of this study is to describe the results of 8 patients, treated for painful chronic hip abductor insufficiency with gluteus maximus muscle transfer, after a minimal follow-up of 24 months including a full clinical and MRI evaluation of the hip abductors pre- and postoperatively. Methods: We retrospectively reviewed a consecutive series of 8 patients who were surgically managed for painful chronic hip abductor insufficiency. All patients had a Trendelenburg sign, impaired muscle strength (M ⩽ 3) as well as a complete avulsion of the hip abductors with marked fatty degeneration (⩾3). Pain levels, muscle strength, functional scores as well as a postoperative MRI was obtained after a minimal follow-up of 24 months. Results: The mean age of the patients was 69 years, mean follow-up was 35 (26–54) months. Pain was significantly reduced postoperatively to VAS 2.5 from VAS 5 (p = 0.046). Trendelenburg sign remained positive in all patients and hip abductor strength did not improve significantly from 2.4 to 3.1 (p = 0.19). Complete healing of the transferred tendon was confirmed by MRI in all patients at last follow-up. Conclusions: In the setting of painful chronic hip abductor insufficiency refractory to conservative treatment with advanced muscle degeneration without the possibility of a direct reconstruction the gluteus maximus tendon transfer significantly decreased pain. The effect on hip abductor strength and patient-reported functional outcome scores is limited. Despite the modest results it remains our preferred salvage treatment option for lack of better alternatives. Larger studies are necessary to confirm these findings. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare seat pressure asymmetries before and after 30 min cycling at constant intensity in association with pelvic anthropometric parameters and skeletal muscle fatigue. Twelve male road cyclists aged 18–30 years (mean training experience 9.9 ± 2.5 years) participated. Pelvic anthropometric data and body composition were measured with dual-energy X-ray absorptiometry. Participants performed 30 min cycling at 50% peak power output at constant intensity on a cyclus-2 ergometer. Muscle fatigue during cycling was assessed by surface electromyogram spectral mean power frequency (MPF) for the back, gluteal, and thigh muscles. The pressure mapping system was used to assess sitting symmetry before and after the cycling exercise. At the end of cycling, MPF was decreased (p < 0.05) in the dominant side's erector spinae muscle and the contralateral gluteal muscle. After the exercise, a significant (p < 0.05) asymmetry in seat pressure was observed under the ischial tuberosity based on the peak pressure right to left ratio, whereas peak pressure decreased under the left ischial tuberosity. After the exercise, the relationship (p < 0.05) between pelvis width and pressure under the ischial tuberosity occurred on the dominant side of the body. In conclusion, an asymmetry was revealed after the constant-load cycling exercise by peak pressure ratio right to left side. Further studies should address the role of seat pressure asymmetries before and after cycling exercises at different intensities and durations. [ABSTRACT FROM AUTHOR]

Quantitative T2‐weighted MRI (T2W) interpretation is impeded by the variability of acquisition‐related features, such as field strength, coil type, signal amplification, and pulse sequence parameters. The main purpose of this work is to develop an automated method for prostate T2W intensity normalization. The procedure includes the following: (i) a deep learning‐based network utilizing MASK R‐CNN for automatic segmentation of three reference tissues: gluteus maximus muscle, femur, and bladder; (ii) fitting a spline function between average intensities in these structures and reference values; and (iii) using the function to transform all T2W intensities. The T2W distributions in the prostate cancer regions of interest (ROIs) and normal appearing prostate tissue (NAT) were compared before and after normalization using Student's t‐test. The ROIs' T2W associations with the Gleason Score (GS), Decipher genomic score, and a three‐tier prostate cancer risk were evaluated with Spearman's correlation coefficient (rS). T2W differences in indolent and aggressive prostate cancer lesions were also assessed. The MASK R‐CNN was trained with manual contours from 32 patients. The normalization procedure was applied to an independent MRI dataset from 83 patients. T2W differences between ROIs and NAT significantly increased after normalization. T2W intensities in 231 biopsy ROIs were significantly negatively correlated with GS (rS = −0.21, p = 0.001), Decipher (rS = −0.193, p = 0.003), and three‐tier risk (rS = −0.235, p < 0.001). The average T2W intensities in the aggressive ROIs were significantly lower than in the indolent ROIs after normalization. In conclusion, the automated triple‐reference tissue normalization method significantly improved the discrimination between prostate cancer and normal prostate tissue. In addition, the normalized T2W intensities of cancer exhibited a significant association with tumor aggressiveness. By improving the quantitative utilization of the T2W in the assessment of prostate cancer on MRI, the new normalization method represents an important advance over clinical protocols that do not include sequences for the measurement of T2 relaxation times. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical efficacy of modified arthroscopic revision release for patients who have gluteal muscle contracture and who have poor outcomes after traditional open surgery. Methods The data of patients who underwent modified arthroscopic revision release for residual symptoms of gluteal muscle contracture after traditional open surgery were retrospectively collected and analyzed. All subjects underwent the procedure between December 2015 and December 2022. The surgical efficacy was assessed by evaluating improvements in specific symptoms, including bilateral lower extremity inequality, hip internal rotation and adduction mobility, squatting with both knees pressed together, and the ability to cross one's legs in supine position, as well as the preoperative and postoperative results for the gluteal muscle contracture functionality scale. Paired t-test was performed to examine whether the differences between preoperative and postoperative measurements were statistically significant. Results A total of 36 patients were followed up systematically, with the mean follow-up period being (22.4±4.9) months. All patients had significantly higher scores for assessment with the gluteal muscle contracture functionality scale at the last follow-up than their preoperative assessment results, showing an increase from the preoperative scores of 40.2±5.5 to 78.4±4.9 (P<0.05). At the follow-up, all patients showed improvement in hip adduction and internal rotation mobility compared with their preoperative status and all patients were able to squat with both knees pressed together. Moreover, only 1 patient still had difficulty in crossing his legs. A total of 27 cases (75%) had preoperative leg length inequality, all of which improved to varying degrees at follow-up. Among all the patients (72 hips/cases), 8 cases had subcutaneous hematomas and incisional ecchymosis, which were resolved after conservative treatments such as hot compresses. 3 cases showed decreased hip abductor strength, but the muscle strength gradually recovered after postoperative exercise and rehabilitation. There were no complications such as subcutaneous exudate, neurovascular injury, or surgical site infection. Conclusion Modified arthroscopic revision release of gluteus muscle contracture is suitable for cases with poor outcomes after conventional open surgery. [ABSTRACT FROM AUTHOR]

Background: The gluteus minimus (GMin) and gluteus medius (GMed) are important dynamic stabilizers of the hip, but quantitative data on their biomechanical roles in stabilizing the hip are currently lacking. Purpose: To (1) establish a reproducible biomechanical cadaveric model of the hip abductor complex and (2) characterize the effects of loading the GMin and GMed on extraneous femoral rotation and distraction. Study Design: Controlled laboratory study. Methods: A total of 10 hemipelvises were tested in 4 muscle loading states: (1) unloaded, (2) the GMin loaded, (3) the GMed loaded, and (4) both the GMin and GMed loaded. Muscle loads were applied via cables, pulleys, and weights attached to the tendons to replicate the anatomic lines of action. Specimens were tested under internal rotation; external rotation; and axial traction forces at 0°, 15°, 30°, 60°, and 90° of hip flexion. Results: When loaded together, the GMin and GMed reduced internal rotation motion at all hip flexion angles (P <.05) except 60° and reduced external rotation motion at all hip flexion angles (P <.05) except 0°. Likewise, when both the GMin and GMed were loaded, femoral distraction was decreased at all angles of hip flexion (P <.05). Conclusion: The results of this study demonstrated that the GMin and GMed provide stability against rotational torques and distractive forces and that the amount of contribution depends on the degree of hip flexion. Clinical Relevance: Improved understanding of the roles of the GMin and GMed in preventing rotational and distractive instability of the hip will better guide treatment of hip pathologies and optimize nonoperative and operative therapies. [ABSTRACT FROM AUTHOR]

The correction of postural weaknesses through the better positioning of the pelvis is an important approach in sports therapy and physiotherapy. The pelvic position in the sagittal plane is largely dependent on the muscular balance of the ventral and dorsal muscle groups. The aim of this exploratory study was to examine whether healthy persons use similar muscular activation patterns to correct their pelvic position or whether there are different motor strategies. The following muscles were recorded in 41 persons using surface electromyography (EMG): M. trapezius pars ascendens, M. erector spinae pars lumbalis, M. gluteus maximus, M. biceps femoris, M. rectus abdominis, and M. obliquus externus. The participants performed 10 voluntary pelvic movements (retroversion of the pelvis). The anterior pelvic tilt was measured videographically via marker points on the anterior and posterior superior iliac spine. The EMG data were further processed and normalized to the maximum voluntary contraction. A linear regression analysis was conducted to assess the relationship between changes in the pelvic tilt and muscle activities. Subsequently, a Ward clustering analysis was applied to detect potential muscle activation patterns. The differences between the clusters and the pelvic tilt were examined using ANOVA. Cluster analysis revealed the presence of four clusters with different muscle activation patterns in which the abdominal muscles and dorsal muscle groups were differently involved. However, the gluteus maximus muscle was involved in every activation pattern. It also had the strongest correlation with the changes in pelvic tilt. Different individual muscle patterns are used by different persons to correct pelvic posture, with the gluteus maximus muscle apparently playing the most important role. This can be important for therapy, as different muscle strategies should be trained depending on the individually preferred motor patterns. [ABSTRACT FROM AUTHOR]

Background and Aims People with postural malalignment such as tibiofemoral varus (TFRV) may experience movement patterns dysfunction during functional activities that are related to non-contact lower extremity injuries. Training protocols should be designed for these people to control and improve their functional dysfunctions. The present study aimed to investigate the effect of posterior X-taping (PXT) and real-time external feedback (RTF) on kinematic and electromyographic indices of the lower extremities during the single-leg squat task in individuals with TFRV. Methods Electromyographic and kinematic information of the lower extremities of 24 recreational athletes with TFRV (PXT=12, RTF=12) were recorded while participants in both groups performed single-leg squat 5 times consecutively and took a 2-minute rest between two different conditions (before and after the intervention). To analyze the data, 2-way analysis of variance and Bonferroni post hoc test were used at the significant level of P≤0.05. Results The present study results indicated an increase in gluteus medius muscle activity (P=0.013) in the eccentric phase and a decrease in hip adduction (P=0.001) in maximal knee flexion (P=0.034) after the intervention compared to before the intervention in the RTF group. Also, there was a reduction in external tibiofemoral rotation of the knee after the intervention compared to before intervention in maximal knee flexion (P=0.034), eccentric phase (P=0.001), and concentric phase (P=0.001) in the PXT group. In addition, there was a decreased ankle pronation after the intervention compared to before the intervention in the eccentric phase (P=0.001) and concentric (P=0.001) in the PXT group and in the eccentric phase (P=0.004) in the RTF group. Besides, there was an increased ankle abduction after the intervention compared to before the intervention in the concentric phase (P=0.001), eccentric phase (P=0.001), and maximum knee flexion (P=0.004) in the PXT group, and in the eccentric phase in the RTF group (P=0.006). Finally, there was a decrease in ankle flexion dorsiflexion at maximum knee flexion after the intervention compared to before the intervention (P=0.017) in the RTF group. Conclusion The results of the present study showed that PXT and RTF interventions can affect the kinematic parameters of individuals with TFRV malalignment in different ways and can be used to correct immediately postural defects during the single-leg squat task. [ABSTRACT FROM AUTHOR]

(1) Background: Leg length discrepancy (LLD), regardless of its origin, is a very common pathology that can contribute to low back pain. Various authors have pointed out its relationship with the lack of activation of both the gluteus medius (GM) and the ipsilateral erector spinae (ES). The purpose of this study was to identify the activation of the ES and GM with different simulated LLDs, correlating this activation with LBP. In turn, we evaluated whether ES and GM activity has an effect on jumping ability using a CMJ test. (2) Method: A sample of healthy subjects was selected to whom an artificial LLD was applied using 0.5, 1, and 1.5 cm insoles. These three heights were measured using EMG while the subjects walked and performed a counter movement jump (CMJ). The measurements of the insole heights were carried out in random order using a Latin square. Muscle activation patterns were recorded for 30 s at each of the insole heights while the patients walked at 5.7 km/h and they were compared with the maximum voluntary contraction (MVC), both on the ipsilateral and contralateral sides. These muscles were then measured under the same circumstances during the performance of the CMJ. (3) Results: We found statistically significant differences in the flight heights in both the CMJ and DJ. In the comparison, significant differences were found in the flight heights of the CMJ and the DJ using the 5 mm insoles, and in the case of the DJ, also without insoles, with respect to the MVC. We found statistically significant differences in the activation of the GM with the differences in insoles, but not in the activation of the Es in relation to the different insole heights. (4) Conclusions: Insoles of different heights caused activation differences in the medius on the side where the insoles were placed. We can relate this difference in activation to LBP. In relation to the ES, no significant differences were found in the activation of the ipsilateral side of the insole. [ABSTRACT FROM AUTHOR]

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

Ankle inversion orientation and peroneal activation insufficiency may contribute to lateral ankle sprains during landing in chronic ankle instability (CAI); however, how anticipation alters these factors is neglected. This study aimed to assess the impact of anticipation on joint orientation and muscle activity during landing in individuals with CAI. Fifteen participants with CAI and 15 healthy participants (control) were recruited to perform single‐leg landings after bilateral countermovement jumps when the landing limb was specified before (planned) or after (unplanned) take‐off. Joint angle (hip, knee, and ankle) and electromyography (gluteus medius, rectus femoris, biceps femoris, gastrocnemius lateral head, tibialis anterior, and peroneal longus) were collected and analyzed with 2 (groups) × 2 (conditions) statistical parametric mapping ANOVA. In the unplanned condition, the CAI group demonstrated a less plantarflexed (maximum difference [MD] = 9.5°, p = 0.047) and more inverted ankle joint (MD = 4.1°, p < 0.001) before ground contact, along with lower peroneal activity at ground contact compared to the control group (MD = 28.9% of peak activation, p < 0.001). No significant differences between groups were observed in the planned condition. In conclusion, anticipation may mask jump landing deficits in people with CAI, including inverted ankle orientation and reduced peroneus longus activity pre‐ and post‐landing, which were observed exclusively in unplanned landings. Clinicians and researchers need to recognize the impact of anticipation on apparent landing deficits and consider the implications for injury prevention and rehabilitation strategies. [ABSTRACT FROM AUTHOR]

Patients with knee osteoarthritis (KOA) might have gait deviations, but few previous studies have discussed gait compensatory movements of the proximal and distal parts of muscle groups related to KOA. The study aimed to measure lumbar and hip movements during gait test and collect muscle activities of the lower extremities. Thirty-four participants with KOA and 28 healthy participants aged over 50 years were recruited for this study. Lumbar and hip motions during walking test were measured using inertial measurement units. Four muscle groups of the lower extremity (erector spinae, gluteus maximus, quadriceps muscle, and gastrocnemius) activities in gait were collected using surface EMGs. KOA patients used an 2.12∘anterior inclined lumbar spine (p = 0.007) and 22.94∘ flexed hip (p = 0.001) in gait compared to healthy participants. The KOA patients had a small hip movement range 30.19∘(p = 0.001) and a higher asymmetric stance time ratio 0.39 (p = 0.006). Patients with KOA showed decreased erector spinae and gluteus maximus muscle activation and increased activation of the quadriceps and gastrocnemius muscles during gait. In conclusion, patients with KOA used a hyperlordotic lumbar and hip flexed strategy, which overactivates distal extensor muscles through the whole gait and might cause overstress on the lower extremity joints. • Investigation on compensatory movements of the proximal and distal parts of muscle groups related to knee osteoarthritis. • Measurement and analysis on lumbar and hip movements and muscle activities collection of lower extremities during gait. • Inertial and surface EMGs measurement performed on 34 participants with KOA and 28 healthy ones. • Patients with KOA using a hyperlordotic lumbar and hip flexed strategy cause overstress on lower extremity joints. [ABSTRACT FROM AUTHOR]

Rauseo, ML, Feairheller, DL, LaRoche, DP, and Cook, SB. Acute effect of dynamic and gluteal resistance exercise warm-up protocols on lower-extremity jump landing mechanics in college-aged females. J Strength Cond Res 38(2): 259-265, 2024--Inadequate neuromuscular control of the femur by the glutealmusculature is associated with noncontact and overuse injuries to the knee. Acute bouts of resistance exercises targeting the gluteal musculature can be prescribed as part of a warm-up protocol with the goal of improving subsequent neuromuscular control and performance. The purpose of this study was to determine the effect that a warm-up protocol including moderate-intensity gluteal resistance exercises (GRE) has on single leg jump landing biomechanics. Seventeen healthy, college-aged, recreationally active females (mean6SD; age521.461.9 years; height5166.965.7 cm; body mass562.567.4 kg) performed 3 single leg hop trials per leg after completing no warm-up (CON), a dynamic warm-up (DWU), and a dynamic warm-up with gluteal resistance exercises (DWU + GRE) across 3 laboratory visits. Lower extremity kinetic and kinematic variables were assessed during single leg hops from the point of initial foot contact to deepest knee flexion. Biomechanical differences between dominant and nondominant limb landings were also assessed. Dominant limb hip internal rotation angle after DWU + GRE (2.03 6 9.92°) was significantly greater (p # 0.05) compared with CON (23.36 6 7.74°). Peak knee adduction moment (56.8%), peak knee flexion angle (5.7%), and peak knee external rotation angle (17.0%) were significantly greater (p # 0.017) in the dominant limb, compared with the nondominant limb, across warm-up protocols. The combined DWU + GRE warm-up protocol did not have a substantial impact on landing biomechanics. Clinicians prescribing GRE before activity should not expect significant changes in movement patterns after a single bout. [ABSTRACT FROM AUTHOR]

Background: Both gluteal and labral tears are common sources of hip pain, but no studies have evaluated how concomitant arthroscopic labral repair and correction of femoroacetabular impingement syndrome (FAIS) affect outcomes after endoscopic gluteus/minimus repair. Purpose: (1) To compare patient-reported outcomes (PROs) and clinically significant outcomes achievements between patients who underwent endoscopic gluteus medius/minimus and arthroscopic hip labral repair with correction of FAIS versus endoscopic gluteus medius/minimus repair without labral repair and (2) to define threshold scores required to achieve the minimal clinically important difference (MCID) and the Patient Acceptable Symptom State (PASS) for the Hip Outcome Score–Activities of Daily Living, Hip Outcome Score–Sports Specific, modified Harris Hip Score (mHHS), 12-item international Hip Outcome Tool, and visual analog scale for pain in these patients. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent primary endoscopic gluteus medius/minimus repair between 2012 and 2020 were identified. Those who underwent concomitant arthroscopic labral repair and correction of FAIS with femoroplasty or acetabuloplasty as indicated were propensity matched in a 1 to 1 ratio by sex, age, and body mass index to patients who underwent gluteus medius/minimus repair without labral repair. Patients who completed the study PROs were assessed preoperatively and at 2 years postoperatively. Threshold scores required to achieve the MCID and PASS thresholds were calculated. Results: A total of 32 patients who underwent simultaneous gluteal and labral repair (G+L) were matched to 32 patients who underwent gluteal repair without labral repair (G); 75% of patients in the G cohort underwent labral debridement, while 25% in this cohort received no labral treatment. A significant difference was observed between groups in preoperative mHHS scores (G+L, 54.4 ± 12.9 vs G, 46.3 ± 14; P =.048) but no differences in any other PRO scores (P ≥.207). The MCID/PASS thresholds were as follows: Hip Outcome Score–Activities of Daily Living (11.14/83.82), Hip Outcome Score–Sports Specific (16.07/59.72), mHHS (11.47/70.95), 12-item international Hip Outcome Tool (13.73/45.49), and visual analog scale for pain (14.30/22). There were no significant differences in MCID or PASS achievement rates between the 2 groups (P ≥.108). Conclusion: Patients who underwent combined G+L demonstrated comparable PROs and clinically significant outcomes achievement rates to patients who underwent G, highlighting sustained successful outcomes for patients with gluteal tendon pathology and concomitant FAIS and labral tears. [ABSTRACT FROM AUTHOR]

Background: The increased expression of the nicotinic acetylcholine receptor (nAChR) in muscle denervation is thought to be associated with electrophysiological acetylcholine supersensitivity after nerve injury. Hence, we investigated the utility of the 18F-ASEM alpha7-nAChR targeting radiotracer as a new diagnostic method by visualizing skeletal muscle denervation in mouse models of sciatic nerve injury. Methods: Ten-week-old C57BL/6 male mice were utilized. The mice were anesthetized, and the left sciatic nerve was resected after splitting the gluteal muscle. One week (n = 11) and three weeks (n = 6) after the denervation, 18F-ASEM positron emission tomography/magnetic resonance imaging (PET/MRI) was acquired. Maximum standardized uptake values (SUVmax) of the tibialis anterior muscle were measured for the denervated side and the control side. Autoradiographic evaluation was performed to measure the mean counts of the denervated and control tibialis anterior muscles at one week. In addition, immunohistochemistry was used to identify alpha7-nAChR-positive areas in denervated and control tibialis anterior muscles at one week (n = 6). Furthermore, a blocking study was conducted with methyllycaconitine (MLA, n = 5). Results: 18F-ASEM PET/MRI showed significantly increased 18F-ASEM uptake in the denervated tibialis anterior muscle relative to the control side one week and three weeks post-denervation. SUVmax of the denervated muscles at one week and three weeks showed significantly higher uptake than the control (P = 0.0033 and 0.0277, respectively). The relative uptake by autoradiography for the denervated muscle was significantly higher than in the control, and immunohistochemistry revealed significantly greater alpha7-nAChR expression in the denervated muscle (P = 0.0277). In addition, the blocking study showed no significant 18F-ASEM uptake in the denervated side when compared to the control (P = 0.0796). Conclusions: Our results suggest that nAChR imaging with 18F-ASEM has potential as a noninvasive diagnostic method for peripheral nervous system disorders. [ABSTRACT FROM AUTHOR]

BACKGROUND: Compound Shengmai Chenggu capsule has good therapeutic effects on early steroid-induced osteonecrosis of the femoral head, but the exact mechanism of treatment is not fully understood. OBJECTIVE: To observe the effect of compound Shengmai Chenggu capsule on fucosyltransferase 8, osteogenic gene and Wnt/β-catenin in bone tissue of rats with steroid-induced osteonecrosis of the femoral head. METHODS: Sixty Sprague-Dawley rats were randomized into blank group, model group, low-, middle-, and high-dose drug groups (n=12 per group). In the latter four groups, animal models of steroid-induced osteonecrosis of the femoral head were established by subcutaneous injection of imiquimod (once every 2 weeks, 2 times in total) and gluteal muscle injection of methylprednisolone (once a week, 4 times in total). The low-, middle- and high-dose drug groups were given 1.89, 3.78 and 7.56 g/kg per day compound Shengmai Chenggu capsule solution by gavage respectively on the second day after the last modeling. The same amount of saline was given by gavage to the model group. Administration lasted 8 weeks. After the administration, micro-CT scan, histological staining, compression test, RT-qPCR and western blot were performed on the femoral head. RESULTS AND CONCLUSION: Micro-CT scan results showed that compared with the blank group, trabecular volume fraction, trabecular number and trabecular thickness were significantly decreased (P < 0.05), while trabecular separation was increased in the model group (P < 0.05). Compared with the model group, the compound Shengmai Chenggu capsule could increase trabecular volume fraction, trabecular number and trabecular thickness (P < 0.05), and decrease trabecular separation (P < 0.05) in a dose-dependent manner. Hematoxylin-eosin staining results showed that compared with the model group, the rate of empty bone lacunae was reduced in a dose-dependent group in the low-, middle-, and high-dose compound Shengmai Chenggu capsule groups (P < 0.05). Immunohistochemical staining results showed that compared with the blank group, the protein expression of fucosyltransferase 8, Runx2 and bone morphogenetic protein 2 was reduced in the model group (P < 0.05); compared with the model group, the compound Shengmai Chenggu capsule increased the protein expression of fucosyltransferase 8, Runx2 and bone morphogenetic protein 2 in a dose-dependent manner (P < 0.05). Results from the compression test showed that there was a dose-dependent increase in the maximum load and elastic modulus of the femoral head in the low-, middle-, and high-dose compound Shengmai Chenggu capsule groups compared with the model group (P < 0.05). RT-qPCR and western blot results showed that the mRNA and protein expressions of fucosyltransferase 8, Runx2, alkaline phosphatase, osteocalcin, osteoblast-specific transcription factor and bone morphogenetic protein 2 were decreased in the model group compared with the blank group (P < 0.05); compared with the model group, there was a dose-dependent increase in the mRNA and protein expressions of the above indicators in the low-, middle-, and high-dose compound Shengmai Chenggu capsule groups compared with the model group (P < 0.05). Compared with the blank group, the mRNA and protein expression of Wnt2, low-density lipoprotein receptor-related protein 5 and β-catenin were decreased (P < 0.05) and the mRNA and protein expressions of glycogen synthase kinase 3β were increased (P < 0.05) in the model group; compared with the model group, there was a dose-dependent increase in the mRNA and protein expressions of Wnt2, low-density lipoprotein receptor-related protein 5 and β-catenin (P < 0.05) but a dose-dependent decrease in the mRNA and protein expressions of lycogen synthase kinase 3β (P < 0.05) in the low-, middle-, and high-dose compound Shengmai Chenggu capsule groups. To conclude, the mechanism by which the compound Shengmai Chenggu capsule treats steroidinduced osteonecrosis of the femoral head may activate the Wnt/β-catenin signaling pathway through the up-regulation of fucosyltransferase 8, thereby promoting bone formation. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to investigate neural patterns within the gluteus maximus (Gmax) muscle to identify optimal EMG placement and injection sites for botulinum toxin and other injectable agents. Methods: This study used 10 fixed and 1 non-fixed adult Korean cadavers. Intramuscular arborization patterns were confirmed in the cranial, middle, and caudal segments of 20 Gmax muscles using Sihler staining. Ultrasound images were obtained from one cadaver, and blue dye was injected using ultrasound guidance to confirm the results. Results: The intramuscular innervation pattern of the Gmax was mostly in the middle part of this muscle. The nerve endings of the Gmax are mainly located in the 40–70% range in the cranial segment, the 30–60% range in the middle segment, and the 40–70% range in the caudal segment. Discussion: Addressing the spasticity of the gluteus maximus requires precise, site-specific botulinum toxin injections. The use of EMG and other injection therapies should be guided by the findings of this study. We propose that these specific sites, which correspond to areas with the densest nerve branches, are the safest and most efficient locations for both botulinum toxin injections and EMG procedures. [ABSTRACT FROM AUTHOR]

Background: In deep gluteal syndrome (DGS), the piriformis muscle could impinge the sciatic nerve. The FAIR (flexion adduction internal rotation) test is a provocation test used to identify sciatic nerve irritation caused by this muscle. Compression and stretching exercises are usually prescribed to treat this syndrome. The aim of this study was to compare the effects of these two treatments on surface electromyography (sEMG) of the gastrocnemius and tibialis anterior in patients with low back pain (LBP) and DGS. Materials and methods: Forty-five participants were allocated to three groups of stretching exercise, compression or control. In addition to 15 min of heat and 15 min of electrical nerve stimulation for pain relief, participants in the compression exercise (CE) group received self-compression exercise, those in the stretching exercise (SE) group received self-stretching exercise and those in the control group received no extra interventions. For the two intervention groups, three sets of two minutes of exercise with two minutes of rest in between were applied. The sEMG amplitude values of the gastrocnemius and tibialis anterior muscles of the affected buttock side of any one group while performing the FAIR test were compared to the others. Pain and disability were assessed and the changes were compared between the two groups. Results: After the intervention period, no group demonstrated a change in the sEMG of the gastrocnemius or tibialis anterior muscles (p > 0.05). There was no difference in the change in this variable between groups (Mean difference (95% CI) of gastrocnemius was ranged over= -4.04 to 7.72 (-19.44 to 23.14); p = 0.603); (Mean difference (95% CI) of tibialis anterior muscles was ranged from − 2.44 to -6.43 (-18.28 to 9.31); p = 0.550).; Pain and disability also decreased significantly in all three study groups (p < 0.05). However, only the disability of patients who performed stretching exercises improved compared to the compression exercise group (Mean difference (95% CI) = -12.62 (-20.41 to -4.38); p = 0.009). Conclusion: Neither stretching nor compression exercises altered the sEMG of the gastrocnemius and tibialis anterior muscles in patients with DGS. Furthermore, performing stretching exercises improved disability compared to the other interventions. Trial registration: The trial was retrospectively registered in the Iranian Registry of Clinical Trials (www.irct.ir) on 10/01/2017 as IRCT201604178035N4. URL of the record: https://en.irct.ir/trial/8473. [ABSTRACT FROM AUTHOR]

Purpose: Previous studies have proven that modifications in the natural walking technique alter muscle activation and energy consumption. This research aimed to determine the differences in muscle activation, energy consumption, kinematic characteristics, perceived muscular exertion and perceived cardio-respiratory fatigue between natural and modified walking techniques with altered pelvic height and rotation. Methods: Nine physically active, non-injured males walked on a treadmill. Modified walking techniques assumed maintenance of constant pelvic height and application of maximal pelvic rotation. Walking speed was subtransit - 0.4 km/h less than the transit. Sampled variables were: average normalized maximal activation during contact and swing phase relativized to maximal voluntary activation, average submaximal oxygen consumption relativized to body mass and subtransit speed, average step length and frequency, rating of perceived muscular exertion and perceived cardio-respiratory fatigue. Muscle activation, energy consumption and kinematic characteristics were assessed throughout each walking session. Perceived muscular exertion and perceived cardio-respiratory fatigue were evaluated post-session. Electromyographic activity was assessed for rectus femoris, gluteus maximus, vastus medialis, biceps femoris, tibialis anterior and gastrocnemius lateralis. Results: The most significant changes in muscle activation were observed during the contact phase. A decrease in pelvic height increased muscle activation of rectus femoris, vastus medialis and gastrocnemius lateralis. An increase in pelvic rotation increased muscle activation of all monitored muscles except for gluteus maximus. Both modifications increased energy consumption, perceived muscular exertion and perceived cardio-respiratory fatigue, and altered kinematic characteristics. Conclusions: Modifications in pelvic height and rotation at the same walking speed alter muscle activation, energy consumption, kinematic characteristics, perceived exertion and fatigue. [ABSTRACT FROM AUTHOR]

Objectives To investigate the efficacy and safety of ultrasound-guided percutaneous irrigation of calcific tendinopathy (US-PICT) applied out of the shoulder, comparing its effectiveness to US-PICT of the rotator cuff. Methods Patients subjected to US-PICT for extra-shoulder calcific tendinitis (Case Group) were compared to those subjected to US-PICT of the rotator cuff (Control Group). We had pre-procedure Visual Analogue Scale (VAS) pain score, 1- and 3-month VAS of patients of the Case Group, pre-procedure and 3-month VAS of patients of the Control Group. Results The Case Group consisted of 41 patients (27 women; mean age: 45 ± 9years): 26 gluteus medius, 5 patellar tendon, 3 rectus femoris, 2 gluteus maximus, 2 common extensor tendon, 1 extensor carpi radialis longus, 1 pes anserinus, and 1 peroneus longus. The Control Group included 41 patients (27 women; mean age: 47 ± 11 years). The mean pre-procedure VAS of the Case Group was 8.8 ± 0.7 with a significant (P  < .001) drop at 1 month (4.5 ± 0.6) and 3 months (3.6 ± 0.6). The mean pre-procedure VAS of the Control Group was 8 ± 1.4 and dropped to 3.1 ± 1.6 after 3 months (P  < .001). Post-treatment VAS at 3 months was not significantly different between two Groups (P  = 0.134). Similarly, the decrease of VAS from baseline to 3 months was not significantly different between the two Groups (P  = 0.264). Conclusions US-PICT is a safe and effective procedure that can be used out of the shoulder. Advances in knowledge This study demonstrated the safety and effectiveness of US-PICT as a valuable therapeutic option for extra-shoulder calcific tendinitis, with similar clinical outcome to the same procedure performed in the rotator cuff. The technique must be adapted in some deeply located calcifications by means of the use of different needles and by thoroughly planning the access point for the procedure. [ABSTRACT FROM AUTHOR]

Objectives: Muscle activity during crouched walking has been previously studied in the context of the evolution of hominin bipedalism and human movement disorders. However, crouched walking could also be used in approach hunting where postural height (actual height of the body from the ground to the top of the head during locomotion) is the limiting factor. Here, we aim to analyze the relationship between relative postural height (%stature), kinematics, and muscle activity during crouched walking. Materials and Methods: Adult males (n = 19) walked with extended limbs and at three degrees of crouch while their 3D motion capture kinematics and lower limb muscle electromyography were recorded. We measured activation of tibialis anterior, soleus, gastrocnemius medialis, gastrocnemius lateralis, vastus lateralis, rectus femoris, biceps femoris, and gluteus maximus. We analyzed the effects of postural height on kinematics and muscle activation using linear mixed effects model. Results: Flexion angles, individual muscle activation (except for medial gastrocnemius), and total muscle activation were negatively related to relative postural height, that is, were greater at more crouched postures. Relative postural height had a stronger effect on the activation of the thigh and gluteal muscles compared to shank muscles. Discussion: General increase in lower limb muscle activation at lower postural heights suggests a negative relationship between relative postural height and fatigue, and may indicate a possible mechanism by which short stature could benefit the hunter in approach hunting. Greater activation of thigh and gluteal muscles relative to shank muscles may help to identify crouched walking in past human populations. [ABSTRACT FROM AUTHOR]

Strengthening of the hip abductors has been advocated for persons with patellofemoral pain (PFP). It is not clear if these individuals activate the hip abductor muscles appropriately to achieve the desired therapeutic effects. To compare activation of the hip abductor muscles between persons with and without PFP during the performance of hip abductor exercises. Thirty-two individuals participated (12 with PFP and 20 without PFP). The average age (± standard deviation) was 29.7 ± 5.9 years for the PFP group and 28.1 ± 6.9 for the control group. Electromyographic (EMG) signals from the gluteus medius (GMED), superior gluteus maximus (SUP-GMAX), and tensor fascia lata (TFL) were obtained using fine-wire electrodes while participants performed 11 different exercises. Normalized EMG activity of each muscle was compared between groups across all exercises. When averaged across all exercises, persons with PFP exhibited significantly greater EMG activity of TFL (mean = 25.3% MVIC; 95% CI = 19.2, 31.3) compared to those without PFP (mean = 17.6% MVIC; 95% CI = 12.8, 22.4) and significantly lower EMG activity of SUP-GMAX (mean = 16.4% MVIC; 95% CI = 11.0, 22.0) compared to those without PFP (mean = 25.4% MVIC; 95% CI = 21.0, 29.8). Persons with PFP exhibited lower EMG activity of GMED, but only for 3 out of the 11 exercises evaluated (hip abduction, hip hike, step-up). Compared to persons without PFP, those with PFP exhibited activation differences during the performance of exercises used to target the hip abductors. Our results highlight the need for activation training prior to the initiation of strengthening exercises to achieve desired therapeutic effects. [ABSTRACT FROM AUTHOR]

Squatting is a common daily activity and fundamental exercise in resistance training and closed kinetic chain programs. The aim of this study was to investigate the effects of an experimentally induced weakness of the gluteal muscles on joint kinematics, reactions forces (JRFs), and dynamic balance performance during deep bilateral squats in healthy young adults. Ten healthy adults received sequential blocks of (1) branch of the superior gluteal nerve to the tensor fasciae latae (SGNtfl) muscle, (2) superior gluteal nerve (SGN), and (3) inferior gluteal nerve (IGN) on the dominant right leg. At the control condition and following each block, the participants were instructed to perform deep bilateral squats standing on two force plates. Hip, knee, ankle, and pelvis kinematics did not differ significantly following iatrogenic weakness of gluteal muscles. The most important finding was the significant differences in JRFs following SGN and IGN block, with the affected hip, patellofemoral, and ankle joint demonstrating lower JRFs, whereas the contralateral joints demonstrated significantly higher JRFs, especially the patellofemoral joint which demonstrated an average maximum difference of 1.43 x body weight compared with the control condition. When performing a deep bilateral leg squat under SGN and IGN block, the subjects demonstrated an increased center of pressure (CoP) range and standard deviation (SD) in mediolateral compared with the control condition. These results imply that squat performance changes significantly following weakness of gluteal muscles and should be considered when assessing and training athletes or patients with these injuries. [ABSTRACT FROM AUTHOR]

Patients with chronic ankle instability (CAI) consistently display postural control alterations, which may result from sensorimotor dysfunction. This study aimed to compare muscle activity in the lower extremity and postural control among individuals with CAI, copers and uninjured controls during a static balance test. A total of 57 physically active participants were categorized into three groups (CAI, copers and controls) and performed a single-leg balance test with two visual conditions: eyes open and eyes closed. Muscle activity in six lower extremity muscles and center of pressure (CoP) variables were recorded and analyzed. Patients with CAI exhibited greater muscle activity in the medial gastrocnemius and gluteus maximus compared to controls or copers, regardless of the visual condition. Copers displayed increased gluteus medius activity compared to controls. Additionally, all groups demonstrated increased muscle activity and CoP variables when visual feedback was disrupted. These findings suggest that patients with CAI may have less effective recruitment of motor units during static balance. On the other hand, greater muscle activity in the gluteus medius in copers may represent a coping mechanism to avoid further ankle injuries. Further research on muscle activity during dynamic postural control is warranted to explore sensorimotor alterations in patients with CAI. [ABSTRACT FROM AUTHOR]

This article, titled "Lower Limb Ischemic Neuropathy Following Uterine Artery Embolization," presents a case study of a 39-year-old woman who was referred to a medical center due to heavy menstrual bleeding caused by intramural fibroids. The woman underwent a procedure called uterine artery embolization (UAE), during which she experienced left gluteal and leg pain that worsened shortly after. Neurological examination revealed pain, numbness, and impaired sensation in her left leg, along with diminished motor power. Imaging tests showed edematous left gluteus muscles with ischemic changes, but no evidence of cord compression or arterial occlusion. The patient was discharged on postoperative day 7 and received outpatient follow-up care. [Extracted from the article]

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Background: Studies have indicated a correlation between patients presenting with decreased gluteus medius function and a history of lumbar pathology (LP). However, literature investigating the relationship between the prevalence of lumbar pathology in patients with gluteus medius tears is lacking. The purpose of this study is to determine if patients undergoing repair for gluteus medius tears have concomitant lumbar pathology. Materials and methods: Patients aged 18-80 who underwent endoscopic gluteus medius repair by one fellowship-trained surgeon between May 2016 and May 2020 for peritrochanteric pain/tenderness, abductor weakness, and MRI findings consistent with a gluteus medius tear were identified. Pre-operative and post-operative data were gathered using the Visual Acuity Scale (VAS), and post-operative data was gathered using the Abbreviated International Hip Outcome Tool (iHOT-12) and Hip Outcome Score -- Activities of Daily Living (HOS-ADL). Outcomes were compared between patients with and without a history of lumbar pathology. Results: Of 23 hips, 19 (82.6%) presented with a prior history of lumbar pathology. Twenty (87.0%) patients identified were female. A total of 19 hips were included with completed PROM scores. Patients with lumbar pathology had similar pre and post-operative patient reported outcomes. Conclusions: This study demonstrates a high incidence of lumbar pathology in patients presenting for operative gluteus medius tears, which may suggest an association between lumbar disease and the development of gluteus medius weakness and tears. [ABSTRACT FROM AUTHOR]

This study aimed to determine the effectiveness of gluteus maximus versus gluteus medius muscle strengthening exercises on the navicular drop (ND), balance, and foot posture index (FPI 6) among athletes with over-pronated feet. A pre-post experimental study design with a total of 54 athletes with bilateral over-pronated feet were randomly assigned into group A (n=18), group B (n=18), and group C (n=18). Medial longitudinal arch height (MLA) was assessed with the Navicular Drop Test, the static and dynamic balance was determined with the stork stance test (SST) and modified Star Excursion Balance Test, and Foot Posture was assessed with Foot Posture Index 6. Multivariate Repeated measures ANOVA was used to analyze the effects of gluteus maximus versus gluteus medius muscle strengthening and short foot exercises. At four weeks, the gluteus medius along with short foot exercises (group B) showed significantly less ND and FPI 6 while showing more excellent SST and modified SEBT than the gluteus maximus muscle strengthening along with short foot exercises (group A) and control group (group C). These results suggest that adding gluteus medius muscle strengthening exercises to short foot exercises (SFE) was more effective in supporting the medial longitudinal arch and improving balance than performing SFE alone. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Low back pain (LBP) is one of the most common conditions in industrialized modern societies. Low back pain is usually nonspecific or mechanical. People with LBP have previously been found to have poor endurance and delayed Gluteus Maximus muscle firing. Anterior pelvic tilt was also believed to cause pelvic girdle discomfort and generalized LBP. Purpose: To evaluate the effectiveness of Gluteus Maximus Activation in correcting anterior pelvic tilt, reducing pain and improving the Functional Outcome among Mechanical Low back pain subjects. Materials and Methods: About 250 participants were selected from Thiraviam Orthopaedic Hospital by using Kinovea software based on inclusion and exclusion criteria. They were divided into 2 groups, Experimental Group (n=125), Control Group (n=125). Both groups were given stretching exercises then Experimental group was given Gluteus Maximus activation exercise with IFT and Control group was given spinal stabilization exercise with IFT. Interventions were given 5 times a week for 6 weeks. Study period : October 2022 to July 2023. Results: Pre-test and post-test values were analyzed and the result suggests that GM Activation Group has significant improvement when compared with Spinal stabilization Group with P<0.0001. Conclusion: According to this study, Gluteus Maximus activation exercises are more effective in correcting anterior pelvic tilt and reducing pain and improving functional outcome among Mechanical Low back pain subjects. [ABSTRACT FROM AUTHOR]

Background: This article emphasizes the importance of the gluteal muscles in children with Down syndrome, revealing their impact on posture and functional movement. Purpose: The motive of this study was to assess the remedial effects of the gluteal muscle exercise regimen as compared to the conventional protocol for Down syndrome and develop the most efficient treatment protocol for children with down syndrome. Materials and Methods: Twelve children with Down syndrome received 8 weeks of continuous therapy, divided into conventional and Gluteal muscle exercise regimen groups using randomization. Pre and post-treatment levels of functional movement and posture were recorded and analyzed using GMFM and Posture Screen Mobile Posture Assessment. Results: The Glutes group showed higher mean GMFM scores and better improvement in posture in 67% of the 6 comparisons, while the remaining subjects didn't show any notable difference. Conclusion: The gluteal muscle exercise regimen group demonstrated more remarkable improvement than the conventional exercise group in both functional movement and posture in children with downs syndrome in a 8 week protocol. [ABSTRACT FROM AUTHOR]

Background: The sacroiliac (SI) joint has been found to be a source of discomfort for 25 to 35% of people suffering from persistent low back pain. Though the Gluteus Maximus and Hamstring muscles play a vital role in sit-to-stand activity in normal people, its role in individuals with sacroiliac joint dysfunction is yet to be studied. Purpose: To assess the association between Gluteus Maximus activity and Hamstring muscle length and determine the efficacy of Gluteus Maximus activation exercise and Hamstring muscle eccentric training on improving sit-to-stand activity in people with SI Joint dysfunction. Materials and Methods: In the first phase of the study, Hamstring muscle length, Gluteus maximus muscle activity, Pain during sit-to-stand activity was recorded. All thirty participants in the second phase of the study underwent six weeks of Hamstring muscle eccentric exercise and Gluteus Maximus muscle activation exercise. Results: A Pearson correlation test shows a positive correlation (r = 0.208) but the weaker relationship between the variables. Paired t test analysis shows a significant improvement after the treatment in terms of Gluteus Maximus muscle activity, Hamstring muscle length and pain reduction with a P value < 0.001. Conclusion: This study concluded that Gluteus Maximus activation exercise and Hamstring muscle eccentric training will significantly improve sit to stand activity and reduce pain. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the level of muscle activity during sprint running using T2-weighted magnetic resonance imaging. Methods: Fourteen male sprinters (age 21.2 [4.0] y; height 171.8 [4.2] cm, weight 65.5 [5.3] kg, 100-m personal record 11.01 [0.41] s; mean [SD]) performed 3 sets of three 60-m round-trip sprints. Before and after the round-trip sprints, 3 T magnetic resonance imaging scans were performed to obtain the T2 values of the 14 athletes' lower-extremity muscles. Results: After the 60-m round-trip sprints, the T2 value of the gluteus maximus, long head of biceps femoris, semitendinosus, semimembranosus, adductor brevis, adductor longus, adductor magnus, and gracilis increased significantly. The rate of change in the T2 values before and after the 60-m round-trip sprints was notably higher in the semitendinosus and gluteus maximus than in the other muscles. Conclusions: These findings demonstrate the specific physiological metabolism of the lower-extremity muscles during fast sprinting. There are particularly high levels of muscle activity in the gluteus maximus and semitendinosus during sprint performance. [ABSTRACT FROM AUTHOR]

The article focuses on ischiofemoral impingement syndrome as an overlooked cause of gluteal pain in a marathon runner initially diagnosed with proximal hamstring tendinopathy. Topics include the diagnostic challenges posed by concurrent conditions, such as dynamic ultrasound imaging revealing quadratus femoris muscle edema, and the successful management with ultrasound-guided steroid injection leading to significant pain reduction and return to competitive running.

This article discusses a case report of a gluteus maximus tear in a pickleball player. The gluteus maximus is a large muscle in the buttocks that plays a significant role in hip extension and maintaining posture. The patient experienced left buttock pain and bruising after sustaining an ankle sprain while playing pickleball. Imaging revealed a partial thickness tear of the gluteus maximus muscle. The patient was managed nonoperatively with compression, icing, acetaminophen, and physical therapy, and was able to return to pickleball within four weeks. The article highlights the successful nonoperative management of this type of injury in athletes. [Extracted from the article]