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Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) 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.)

Measuring joint range of motion has traditionally occurred with a universal goniometer, inclinometer, or expensive laboratory systems. The popularity of the inertial measurement unit (IMU) is growing, enabling the small and even single portable device to measure the range of motion. Until now, they were not used to assess hip joint range of motion. Our study aimed to check the validity of IMUs in assessing hip range of motion and compare them to other measurement devices—universal goniometer and inclinometer. Twenty participants completed three hip movements (flexion in standing and prone internal and external rotation) on both hips. Two testers independently assessed each movement with a goniometer, digital inclinometer, and IMU at different time points. To assess the agreement of active hip ROM between devices, Intraclass Correlation Coefficient (ICC) and Bland–Altman analysis were used. Furthermore, inter-rater and intra-rater reliability were also assessed by using ICC and Bland–Altman analysis. Limits of agreement (LOA) were calculated using Bland–Altman plots. The IMU demonstrated good to excellent validity (ICC: 0.87–0.99) compared to the goniometer and digital inclinometer, with LOAs < 9°, across all tested movements. Intra-rater reliability was excellent for all devices (ICC: 0.87–0.99) with LOAs < 7°. However, inter-rater reliability was moderate for flexion (ICC: 0.58–0.59, LOAs < 22.4) and poor for rotations (ICC: −0.33–0.04, LOAs < 7.8°). The present study shows that a single inertial measurement unit (RSQ Motion, RSQ Technologies, Poznan, Poland) could be successfully used to assess the active hip range of motion in healthy subjects, comparable to other methods accuracy. [ABSTRACT FROM AUTHOR]

Context: Compared to shoulder and elbow functions, the hip functional characteristics of baseball pitchers have not been fully investigated. Therefore, little is known about the relationship between hip function and pitching performance. Objective: The purpose of this study was to evaluate the characteristics of hip flexibility and strength, focusing on their influences on the ball velocity in baseball pitchers. Design: Descriptive laboratory study. Setting: Laboratory and university baseball facility. Participants: Twenty-three college baseball pitchers. Interventions: Passive hip range of motion (ROM) and isometric hip muscle strength were bilaterally measured. The pitchers threw 20 fastballs at an official pitching distance. Main Outcome Measures: Bilateral hip ROM and strength in flexion, extension, abduction, adduction, and external and internal rotation; the maximal ball velocity. Results: The pivot side showed smaller hip external rotation ROM (P< .01), larger hip internal rotation ROM (P = .03), and greater hip adduction strength (P = .03) than the stride side. The hip extension ROM on the stride side had a negative correlation with the maximal ball velocity (r = -.58, P < .01). The maximal ball velocity (135.3 [4.1] km/h) positively correlated with the hip extension (r=.59, P< .01), flexion (r= .57, P<.01), abduction (r=.55, P< .01), and adduction (r=.55, Pc.Ol) strength on the pivot leg, and the hip flexion (r=.53, P=.01), abduction (r=.67, P<.01), and adduction (r=.46, P= .03) strength on the stride leg. Conclusions: These findings suggest that baseball pitchers do not have marked side-to-side differences in hip flexibility and strength, and that an important fitness factor for increasing ball velocity is not the hip flexibility but the hip muscle strength of both legs. [ABSTRACT FROM AUTHOR]

Background: Tele-health has become a major mode of delivery in patient care, with increasing interest in the use of tele-platforms for remote patient assessment. The use of smartphone technology to measure hip range of motion has been reported previously, with good to excellent validity and reliability. However, these smartphone applications did not provide real-time tele-assessment functionality. We developed a novel smartphone application, the TelePhysio app, which allows the clinician to remotely connect to the patient's device and measure their hip range of motion in real time. The aim of this study was to investigate the concurrent validity and between-sessions reliability of the TelePhysio app. In addition, the study investigated the concurrent validity, between-sessions, and inter-rater reliability of a second tele-assessment approach using video analysis. Methods: Fifteen participants (nfemales = 6) were assessed in our laboratory (session 1) and at their home (session 2). We assessed maximum voluntary active hip flexion in supine and hip internal and external rotation, in both prone and sitting positions. TelePhysio and video analysis were validated against the laboratory's 3-dimensional motion capture system in session 1, and evaluated for between-sessions reliability in session 2. Video analysis inter-rater reliability was assessed by comparing the analysis of two raters in session 2. Results: The TelePhysio app demonstrated high concurrent validity against the 3D motion capture system (ICCs 0.63–0.83) for all hip movements in all positions, with the exception of hip internal rotation in prone (ICC = 0.48, p = 0.99). The video analysis demonstrated almost perfect concurrent validity against the 3D motion capture system (ICCs 0.85–0.94) for all hip movements in all positions, with the exception of hip internal rotation in prone (ICC = 0.44, p = 0.01). The TelePhysio and video analysis demonstrated good between-sessions reliability for hip external rotation and hip flexion, ICC 0.64 and 0.62, respectively. The between-sessions reliability of hip internal and external rotation for both TelePhysio and video analysis was fair (ICCs 0.36–0.63). Inter-rater reliability ICCs for the video analysis were 0.59 for hip flexion and 0.87–0.95 for the hip rotation range. Conclusions: Both tele-assessment approaches, using either a smartphone application or video analysis, demonstrate good to excellent concurrent validity, and moderate to substantial between-sessions reliability in measuring hip rotation and flexion range of motion, but less in internal hip rotation in the prone position. Thus, it is recommended that the seated position be used when assessing hip internal rotation. The use of a smartphone to remotely assess hip range of motion is an appropriate, effective, and low-cost alternative to the face-to-face assessments. This method provides a simple, cost effective, and accessible patient assessment tool with no additional cost. This study validates the use of smartphone technology as a tele-assessment tool for remote hip range of motion assessment. [ABSTRACT FROM AUTHOR]

Measuring joint range of motion has traditionally occurred with a universal goniometer, inclinometer, or expensive laboratory systems. The popularity of the inertial measurement unit (IMU) is growing, enabling the small and even single portable device to measure the range of motion. Until now, they were not used to assess hip joint range of motion. Our study aimed to check the validity of IMUs in assessing hip range of motion and compare them to other measurement devices—universal goniometer and inclinometer. Twenty participants completed three hip movements (flexion in standing and prone internal and external rotation) on both hips. Two testers independently assessed each movement with a goniometer, digital inclinometer, and IMU at different time points. To assess the agreement of active hip ROM between devices, Intraclass Correlation Coefficient (ICC) and Bland–Altman analysis were used. Furthermore, inter-rater and intra-rater reliability were also assessed by using ICC and Bland–Altman analysis. Limits of agreement (LOA) were calculated using Bland–Altman plots. The IMU demonstrated good to excellent validity (ICC: 0.87–0.99) compared to the goniometer and digital inclinometer, with LOAs < 9°, across all tested movements. Intra-rater reliability was excellent for all devices (ICC: 0.87–0.99) with LOAs < 7°. However, inter-rater reliability was moderate for flexion (ICC: 0.58–0.59, LOAs < 22.4) and poor for rotations (ICC: −0.33–0.04, LOAs < 7.8°). The present study shows that a single inertial measurement unit (RSQ Motion, RSQ Technologies, Poznan, Poland) could be successfully used to assess the active hip range of motion in healthy subjects, comparable to other methods accuracy.

Background:Although restricted hip range of motion (ROM) is associated with an increased risk for injuries in baseball players, the evolution of hip ROM over the season remains undefined. Hypothesis:Hip ROM profiles would be symmetric between hips and positions (pitchers vs position players) but would decrease from preseason to postseason. Additionally, it was hypothesized that this decrease in motion would correlate with workload. Study Design:Cohort study; Level of evidence, 2. Methods:Bilateral hip ROM was assessed in 96 professional baseball players (54 pitchers, 42 position players) preseason and postseason. ROM comparisons were made between lead and trailing hips, pitchers and position players, and preseason and postseason measures. The change from preseason to postseason was correlated with player demographics and measures of workload for pitchers and position players. Results:Preseason hip ROM was symmetric between hips; however, pitchers demonstrated increased preseason lead hip internal rotation (IR) (P = .018) and bilateral hip total ROM (TROM) (P < .020) compared with position players. From preseason to postseason, position players lost 7° of external rotation (ER) (P ≤ .005 ). In pitchers, the loss of IR correlated with increased pitches (P = .016) and innings (P = .037), while the loss of ER (P = .005 ) and TROM (P = .014) correlated with increasing mean fastball velocity. Workload for position players did not correlate with motion loss. Conclusion:Symmetric hip ROM profiles should be anticipated in baseball players; however, pitchers may have increased preseason IR and TROM and postseason ER and TROM relative to position players. Although loss of motion correlated with workload in pitchers, this was not the case for position players. Hip motion should be monitored over the course of the season. This is particularly true for pitchers who lose IR as workload increases, which may place them at a greater risk for injuries.

Purpose: Foam rolling is frequently implemented in warm-up prior to an exercise session. The purpose of this study was to evaluate the acute effects of a short bout of foam rolling on maximal knee flexion strength along with active and passive hamstring flexibility. Methods: Fourteen healthy young participants were included in this within-subject randomized controlled trial. After warm-up a short bout (two sets of 60 s) of foam rolling was performed on the intervention leg (counterbalanced leg dominance) while the contralateral leg was used as a control. Measurement of peak knee flexion torque and hamstring passive and active range of motion were performed on both sides in counterbalanced order. An analysis of variance was conducted to evaluate differences between the two groups. Results: Our results did not show significant differences between the intervention and control leg for any of the assessed parameters. Conclusion: The main findings are that a short bout of foam rolling does not affect maximal knee flexion strength and that the foam rolling intervention does not further affect flexibility although hamstring passive flexibility increases following a warm-up. Based on our results we conclude that short bouts of foam rolling can be used prior to exercise, as they have no deleterious effect on muscle performance. Foam rolling before exercise should be recommended solely based on individual preference. [ABSTRACT FROM AUTHOR]

Background: The most reliable suture technique for capsular closure after a capsulotomy remains unknown. Purpose: To determine which suture technique best restores native stability after a 5-cm interportal capsulotomy. Study Design: Controlled laboratory study. Methods: Ten human cadaveric hip specimens were tested using a 6-degrees-of-freedom robotic arm in 7 states: intact, capsular laxity, 5-cm capsulotomy, standard suture, shoelace, double shoelace, and Quebec City slider (QCS). Rotational range of motion (ROM) was measured across 9 tests: flexion, extension, abduction, abduction at 45° of flexion, adduction, external rotation, internal rotation, anterior impingement, and log roll. Distraction (ie, femoral head translation [FHT]) was measured across a range of flexion and abduction angles. Results: When compared with the native state, the 5-cm capsulotomy state showed the largest laxity increases on all tests, specifically in external rotation ROM (+13.4°), extension ROM (+11.5°), and distraction FHT (+4.5 mm) (P <.001 for all). The standard suture technique was not significantly different from the 5-cm capsulotomy on any test and demonstrated significantly more flexion ROM than the double shoelace suture (+1.41°; P =.049) and more extension ROM (+5.51°; P =.014) and external rotation ROM (+6.03°; P =.021) than the QCS. The standard suture also resulted in significantly higher distraction FHT as compared with the shoelace suture (+1.0 mm; P =.005), double shoelace suture (+1.4 mm; P <.001), and QCS (+1.1 mm; P =.003). The shoelace, double shoelace, and QCS techniques significantly reduced hip laxity when compared with the 5-cm capsulotomy state, specifically in external rotation ROM (respectively, –8.1°, –7.8°, and –10.2°), extension ROM (–6.3°, –7.3°, and –8.1°), and distraction FHT (–1.8, –2.2, and –1.9 mm) (P ≤.003 for all). These 3 techniques restored native stability (no significant difference from intact) on some but not all tests, and no significant differences were observed among them on any test. Conclusion: Hip capsule closure with the standard suture technique did not prevent postoperative hip instability after a 5-cm capsulotomy, and 3 suture techniques were found to be preferable; however, none perfectly restored native stability at time zero. Clinical Relevance: The shoelace, double shoelace, and QCS suture techniques are recommended when closing the hip capsule. [ABSTRACT FROM AUTHOR]

Abstract Background The demand for total hip arthroplasty (THA) is quickly rising given the escalating global incidence of hip osteoarthritis, and it is widely accepted that the post-surgery rehabilitation is key to optimize outcomes. The overall objective of this study is to evaluate the effectiveness of a new telerehabilitation solution, ReHub, for the physical function and clinical outcome improvement following THA. The specific aims of this manuscript are to describe the study design, protocol, content of interventions, and primary and secondary outcomes and to discuss the clinical rehabilitation impact of the expected experimental results. Methods/design This prospective, randomized, controlled, parallel-group trial will include 56 patients who had undergone primary THA. Patients are randomized to a control group (standard rehabilitation during the 2-week stay in the rehabilitation clinic followed by 3 weeks of unsupervised home-based rehabilitation) or an experimental group (standard rehabilitation during the 2-week stay in the rehabilitation clinic followed by 3 weeks of home-based ReHub-assisted telerehabilitation). The primary outcome is physical performance assessed through the Timed Up-and-Go (TUG) test. Secondary outcomes include independence level, pain intensity, hip disability, hip range of motion, muscle strength, and patient’s perception of clinical improvement. Discussion Proving the clinical and cost-effectiveness of a home-based telerehabilitation program for physical and muscle function following THA could support its systematic incorporation in post-surgical rehabilitation protocols, which should be tailored to the individual and collective needs. Trial registration ClinicalTrial.gov NCT04176315 . Registered on 22 November 2019

Background: Tele-health has become a major mode of delivery in patient care, with increasing interest in the use of tele-platforms for remote patient assessment. The use of smartphone technology to measure hip range of motion has been reported previously, with good to excellent validity and reliability. However, these smartphone applications did not provide real-time tele-assessment functionality. We developed a novel smartphone application, the TelePhysio app, which allows the clinician to remotely connect to the patient’s device and measure their hip range of motion in real time. The aim of this study was to investigate the concurrent validity and between-sessions reliability of the TelePhysio app. In addition, the study investigated the concurrent validity, between-sessions, and inter-rater reliability of a second tele-assessment approach using video analysis. Methods: Fifteen participants (nfemales = 6) were assessed in our laboratory (session 1) and at their home (session 2). We assessed maximum voluntary active hip flexion in supine and hip internal and external rotation, in both prone and sitting positions. TelePhysio and video analysis were validated against the laboratory’s 3-dimensional motion capture system in session 1, and evaluated for between-sessions reliability in session 2. Video analysis inter-rater reliability was assessed by comparing the analysis of two raters in session 2. Results: The TelePhysio app demonstrated high concurrent validity against the 3D motion capture system (ICCs 0.63–0.83) for all hip movements in all positions, with the exception of hip internal rotation in prone (ICC = 0.48, p = 0.99). The video analysis demonstrated almost perfect concurrent validity against the 3D motion capture system (ICCs 0.85–0.94) for all hip movements in all positions, with the exception of hip internal rotation in prone (ICC = 0.44, p = 0.01). The TelePhysio and video analysis demonstrated good between-sessions reliability for hip external rotation and hip flexion, ICC 0.64 and 0.62, respectively. The between-sessions reliability of hip internal and external rotation for both TelePhysio and video analysis was fair (ICCs 0.36–0.63). Inter-rater reliability ICCs for the video analysis were 0.59 for hip flexion and 0.87–0.95 for the hip rotation range. Conclusions: Both tele-assessment approaches, using either a smartphone application or video analysis, demonstrate good to excellent concurrent validity, and moderate to substantial between-sessions reliability in measuring hip rotation and flexion range of motion, but less in internal hip rotation in the prone position. Thus, it is recommended that the seated position be used when assessing hip internal rotation. The use of a smartphone to remotely assess hip range of motion is an appropriate, effective, and low-cost alternative to the face-to-face assessments. This method provides a simple, cost effective, and accessible patient assessment tool with no additional cost. This study validates the use of smartphone technology as a tele-assessment tool for remote hip range of motion assessment.

Background Hip range of motion (ROM) during baseball pitching is associated with trunk rotation and shoulder kinematics, which has shown to influence medial elbow valgus loading and pitching performance. The purpose of this study was to measure the relationship between hip rotational ROM and kinematic variables that influence elbow valgus loads in Division 1 collegiate pitchers. Study Design Descriptive laboratory study. Methods Three-dimensional pitching motion (Motion Analysis Corp, Santa Rosa, California) analyses were captured for seven Division 1 baseball pitchers. Six kinematic measurements related to medial elbow valgus loading were calculated while the pitchers threw fastballs. Inclinometer measurements were used to measure hip internal (IR), external (ER) ROM, and total rotational arc at the hip (IR + ER ROM). Correlations were used to evaluate the association between hip IR, ER, and total rotational arc ROM (TRARC) and six kinematic variables. Results Trunk angular velocity was correlated to trail hip ER and TRARC (p <0.01). Lead hip total arc ROM was associated with maximum shoulder ER (p < 0.01). Lead hip IR was correlated to elbow flexion angle at ball release (p < 0.01). Conclusion Hip ROM during pitching is associated with trunk angular velocity, maximum shoulder ER and elbow flexion angle at ball release. Alterations in hip TRARC appears to influence trunk rotation velocity leading to dependence on increased shoulder ROM and decreased elbow flexion angle at ball release which is associated with diminished pitching performance and excessive medial elbow valgus loads. Level of Evidence level 3 [ABSTRACT FROM AUTHOR]

Background: While modern hip replacement planning relies on hip motion simulation (HMS), it lacks the capability to include soft-tissues and ligaments restraints on computed bony range of motion (BROM), often leading to an overestimation of the in-vivo functional range of motion (FROM). Furthermore, there is a lack of literature on BROM assessment in relation to FROM. Therefore, the study aimed to assess computed BROM using in-vitro cadaver-derived FROM measurements, registered to a CT-based in-house HMS, and to further investigate the effect of functional and anatomical hip joint centres (FHJC and AHJC) on BROM., Method: Seven limiting and three non-limiting circumducted passive FROM of four cadaver hips were measured using optical coordinate measuring machine with reference spheres (RSs) affixed to the pelvis and the femur, following CT-scan of the specimen. The RSs' centres were used to register the measured FROM in HMS, enabling its virtual recreation to compute corresponding BROM by detecting nearest bony impingement. FHJC, estimated from non-limiting FROM, was compared with AHJC to examine their positional differences and effect on BROM., Results: Differences in BROM and FROM were minimal in deep flexion (3.0° ± 4.1°) and maximum internal rotation (IR) at deep flexion (3.0° ± 2.9°), but substantially greater in extension (53.2° ± 9.5°). Bony impingement was observed during flexion, and IR at deep flexion for two hips. The average positional difference between FHJC and AHJC was 3.1 ± 1.2 mm, resulting in BROM differences of 1°-13° across four motions., Conclusions: The study provided greater insight into the applicability and reliability of computed BROM in pre-surgical planning., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The demand for total hip arthroplasty (THA) is quickly rising given the escalating global incidence of hip osteoarthritis, and it is widely accepted that the post-surgery rehabilitation is key to optimize outcomes. The overall objective of this study is to evaluate the effectiveness of a new telerehabilitation solution, ReHub, for the physical function and clinical outcome improvement following THA. The specific aims of this manuscript are to describe the study design, protocol, content of interventions, and primary and secondary outcomes and to discuss the clinical rehabilitation impact of the expected experimental results.Methods/design: This prospective, randomized, controlled, parallel-group trial will include 56 patients who had undergone primary THA. Patients are randomized to a control group (standard rehabilitation during the 2-week stay in the rehabilitation clinic followed by 3 weeks of unsupervised home-based rehabilitation) or an experimental group (standard rehabilitation during the 2-week stay in the rehabilitation clinic followed by 3 weeks of home-based ReHub-assisted telerehabilitation). The primary outcome is physical performance assessed through the Timed Up-and-Go (TUG) test. Secondary outcomes include independence level, pain intensity, hip disability, hip range of motion, muscle strength, and patient's perception of clinical improvement.Discussion: Proving the clinical and cost-effectiveness of a home-based telerehabilitation program for physical and muscle function following THA could support its systematic incorporation in post-surgical rehabilitation protocols, which should be tailored to the individual and collective needs.Trial Registration: ClinicalTrial.gov NCT04176315 . Registered on 22 November 2019. [ABSTRACT FROM AUTHOR]

Traditional studies of hip kinematics have not identified which anatomic structures limit the range of motion (ROM) when the hip is placed in different maneuvers. In this study, we attempted to answer two questions: (a) During which maneuvers is the motion of the hip limited by bony impingement between the femur and pelvis? (b) When is hip ROM determined by the constraint of soft tissues and to what extent? ROM of eight cadaveric hips was measured in 17 maneuvers using a motion capture system. The maneuvers were recreated in silico using 3D CT models of each specimen to detect the occurrence of bony impingement. If bony impingement was not detected, the variable component of 3D hip motion was increased until a collision was detected. The difference between the virtual ROM at the point of bony impingement and the initial ROM measured experimentally was termed as the soft‐tissue restriction. The results showed that bony impingement was present in normal hips during maneuvers consisting of high abduction with flexion, and high flexion combined with adduction and internal rotation. At impingement‐free maneuvers, the degree of soft tissue restriction varies remarkably, ranging from 4.9° ± 3.8° (internal rotation) at 90° of flexion to 80.0° ± 12.5° (internal rotation) at maximum extension. The findings shed light on the relative contributions of osseous and soft tissues to the motion of the hip in different maneuvers and allow for a better understanding of physical exams of different purposes in diagnosing bone‐ or soft tissue‐related diseases. [ABSTRACT FROM AUTHOR]

Evidence is scarce concerning the relationship of physical dysfunction of the trunk and lower extremities with elbow and shoulder pain in young baseball players. This study aimed to examine the association of joint flexibility of the trunk and lower extremities and dynamic postural control with elbow and shoulder pain among elite young baseball players. We analyzed baseball players (aged 9-12 years) who participated in the National Junior Sports Clubs Baseball Festival. Range of motion in external rotation and internal rotation (IR) of the hip, as well as the finger-to-floor distance and heel-to-buttock distance, was measured. The straight-leg-raise test was also conducted. Dynamic postural control was evaluated using the Star Excursion Balance Test. Multivariable logistic regression analyses were conducted to examine the association of physical function with the elbow or shoulder pain incidence. Of 210 players surveyed, 177 without elbow or shoulder pain were included in the analysis. Of the participants, 16 (9.0%) reported having elbow or shoulder pain during the tournament. Participants with the incidence of elbow or shoulder pain had a significant restriction in hip IR of the stride leg compared with those without pain (35.8° vs. 43.7°, P =.022). There were no significant associations of other joint flexibilities and the Star Excursion Balance Test with elbow or shoulder pain. Decreased hip IR range of motion of the stride leg was significantly associated with the elbow or shoulder pain incidence. Players, coaches, and clinicians should consider the physical function of the trunk and lower extremities for the prevention of elbow and shoulder pain. [ABSTRACT FROM AUTHOR]

Copyright of Rigakuryoho Kagaku is the property of International Press Editing Center Incorporation 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: Reductions in hip range of motion (ROM) correlate with lower extremity injury and alterations in shoulder mechanics in overhead athletes. Such shifts in kinetic-chain dynamics may lead to additional stresses at common injury sites of the upper and lower extremities. Researchers have suggested that Total Motion Release® (TMR®) increases shoulder ROM more effectively than traditional warm-up methods. It is plausible that similar methods may produce increases in ROM at the hip. Purpose: To explore the effects of a TMR® based intervention on active hip rotational ROM in overhead athletes compared to a traditional athletic warm-up. Study Design: Randomized Control Trial. Methods: Twenty-two secondary school, NCAA Division I, III, and Club student-athlete participants (sex: 13 females, 9 males; sport: 9 javelin, 7 volleyball, 7 baseball; age= 19.3 ± 1.1 years; height= 178 ± 11.4 cm; weight = 76.4 ± 11.2 kg.) were randomly assigned to TMR® (TMRG; n=11) and traditional warm-up (TWG; n=11) groups. The TMRG performed three sets of forward flexed trunk twist and seated straight leg raise held for 20 seconds each to the side of ease with a 30-second rest interval. Active hip internal and external rotation was measured using the Clinometer smartphone application immediately before and after intervention. Results: The TMRG experienced significant immediate increases in active dominant hip ER,, active nondominant hip ER, active dominant total hip rotational ROM, and active nondominant total hip rotational ROM (mean change = +6.27°, +12.2o, +4.8, and +11.9o), compared to the TWG (mean change = +0°, +1.9°, -1°, and 1°) respectively. Conclusion: Using TMR® motions and principles as a warm-up produced meaningful changes in active hip rotational ROM bilaterally in overhead athletes. Level of Evidence: IIb [ABSTRACT FROM AUTHOR]

BACKGROUND: Groin injury and groin symptoms are common in soccer players. The relationship of groin injury and groin symptoms to reduced hip range of motion (ROM) and previous injury is unclear. OBJECTIVES: To conduct a retrospective assessment of associations between previous injury and preseason hip ROM and preseason prevalence of severe groin symptoms, and to prospectively identify risk factors for within-season groin injury. METHODS: During the period of 2015 to 2016, 190 players from 9 Dutch professional soccer clubs participated in this cohort study with prospective and retrospective elements. Univariate and multivariate logistic regressions were used to predict preseason severe groin symptoms, identified using the Copenhagen Hip and Groin Outcome Score, from a history of previous groin injury, general injury (minimum of 1 week in duration) in the previous season, and hip ROM. Cox regression was used to predict within-season groin injury. RESULTS: Point prevalence of severe groin symptoms was 24% and within-season incidence of groin injury was 11%. Total, training, and match groin injury incidences were 0.5, 0.2, and 2.6 injuries per 1000 playing hours, respectively. A history of more than 1 previous groin injury was associated with current severe groin symptoms (odds ratio = 3.0; 95% confidence interval: 1.0, 8.3; P = .038). General injury sustained in the previous season (ankle, knee, thigh, shoulder; median, 9 weeks of time loss) was a risk factor for groin injury (hazard ratio = 5.1; 95% confidence interval: 1.8, 14.6; P = .003). U UCONCLUSION: Severe injuries in the previous season to locations other than the groin increase the risk of groin injury the next season. A history of groin injury is associated with current severe groin symptoms. Preseason hip ROM does not identify players at risk for groin injury. U ULEVEL OF EVIDENCE: Prevention, level 2b. [ABSTRACT FROM AUTHOR]

We aimed to measure the posterior pelvic tilt angle at maximum hip flexion and hip flexion range of motion at the femoroacetabular joint using a pelvic guide pin and to examine the difference in flexion range of motion when determined by a physical therapist and under anesthesia. Data of 83 consecutive patients undergoing primary unilateral total hip arthroplasty were assessed. Using a pin inserted into the iliac crest to define the cup placement angle under anesthesia before and after total hip arthroplasty, the posterior pelvic tilt angle was determined as the change in pin tilt from the supine position to maximum hip flexion. Flexion range of motion under anesthesia was calculated as the difference in the angle between the trunk and thigh at maximum flexion and the posterior pelvic tilt angle. Flexion range of motion with a fixed pelvis measured preoperatively by a physical therapist was compared to that under anesthesia. A goniometer was used for all measurements and the number of measurements was one. Mean posterior pelvic tilt angle of the pin inserted into the pelvis under anesthesia was 15.8° ± 5.3° (3°–26°) preoperatively and 12.1° ± 4.9° (3°–26°) postoperatively. Mean flexion range of motion under anesthesia was 109.4° ± 6.9° (88°–126°) and that measured by a physical therapist was 101.1° ± 8.2° (80°–120°); the difference was significant (9.7°; p < 0.01). These results highlight the difficulty in accurately determining hip flexion angles without the use of special devices and may help surgeons and physical therapists recognize and address this issue. • Flexion angles at the femoroacetabular joint were studied. • Measurements made under anesthesia and by a physical therapist differed. • The posterior pelvic tilt angle is easily included when measuring hip flexion. • Clinical decisions should be made based on accurate range of motion data. [ABSTRACT FROM AUTHOR]

Normal hip range of motion (ROM) is essential in running and transfer of energy from lower to upper extremities during overhead throwing. Dysfunctional hip ROM may alter lower extremity kinematics and predispose athletes to hip and groin injuries. The purpose of this study is characterize hip internal/external ROM (Arc) and its effect on the risk of hip, hamstring, and groin injuries in professional baseball players. Bilateral hip internal and external ROM was measured on all baseball players (N=201) in one professional organization (major and minor league) during spring training. Players were organized according to their respective positions. All injuries were documented prospectively for an entire MLB season (2010 to 2011). Data was analyzed according to position and injuries during the season. Total number of players (N=201) with an average age of 24±3.6 (range=17-37). Both pitchers (N=93) and catchers (N=22) had significantly decreased mean hip internal rotation and overall hip arc of motion compared to the positional players (N=86). Players with hip, groin, and hamstring injury also had decreased hip rotation arc when compared to the normal group. Overall, there is a correlation between decreased hip internal rotation and total arc of motion with hip, hamstring, and groin injuries.

Currently, there exists a need for a more thorough understanding of native hip joint kinematics to improve the understanding of pathological conditions, injury mechanisms, and surgical interventions. A biomechanical testing system able to accomplish multiple degree-of-freedom (DOF) movements is required to study the complex articulation of the hip joint. Therefore, the purpose of this study was to assess the repeatability and comparative accuracy of a 6 DOF robotic system as a testing platform for range of motion in vitro hip biomechanical analysis. Intact human cadaveric pelvises, complete with full femurs, were prepared, and a coordinate measuring machine collected measurements of pertinent femoral and pelvic bony landmarks used to define the anatomic hip axes. Passive flexion/extension path and simulated clinical exam kinematics were recorded using a 6 DOF robotic system. The results of this study demonstrate that the 6 DOF robotic system was able to identify hip passive paths in a highly repeatable manner (median RMS error of <0.1 mm and <0.4°), and the robotically simulated clinical exams were consistent and repeatable (rotational RMS error ≤0.8°) in determining hip ranges of motion. Thus, a 6 DOF robotic system is a valuable and effective tool for range of motion in vitro hip biomechanical analysis. [ABSTRACT FROM AUTHOR]

Abnormalities in hip morphology can reduce range of motion (ROM) through femoroacetabular impingement (FAI). Structural issues, such as asphericity of the head-neck junction and regional or global acetabular over-coverage, have been extensively discussed in the literature. The effect of varying femoral neck-shaft angle or torsion on native hip range of motion, however, has been poorly studied. Our hypothesis was that varying neck-shaft angles or femoral torsion affect the impingement-free ROM of the hip and can be treated by femoral osteochondroplasty or acetabular rim resection.~Introduction~Background~A computer-aided design tool and a 3-D model of the hip were used to simulate incremental deformation of the proximal femur. Neck-shaft angles ranging from 90-160°, and femoral torsions ranging from -15-50°, were created. Femoroacetabular impingement was defined as bone-to-bone contact within physiological hip ROM, as described in the literature.~Material and Methods~Methods~With decreasing neck-shaft angles (¿110°) or femoral torsion (¿10°), impingement occurred at the anterosuperior rim area. With increasing neck-shaft angles (¿135°) and femoral torsion (¿25°) posteroinferior or ischiofemoral impingement occurred. Acetabular rim trimming could compensate for neck-shaft angles ¿90° and femoral torsion ¿-5°, without creating acetabular dysplasia. Femoral impingement zones in low neck-shaft and low femoral torsion angles were found to be distal to the head-neck junction at the mid-cervical region. The cross-sectional area at this neck region was the smallest, and thus osteochondroplasty at this location may prove potentially dangerous.~Results and Conclusion~Conclusions [ABSTRACT FROM AUTHOR]

The article presents a study that investigates the effectiveness of home exercise program targeted at the hip in people with non-specific chronic or recurrent low back pain (LBP) with concurrent reduced hip rotation. Thirty participants are assigned in three exercise programs such as hip rotation stretching, hip strengthening and multi-directional hip stretching. It is suggested that all exercises improve pain and function.

This article examines whether foam rolling the anterior thigh of an athlete can help him or her increase the range of motion when extending hip in a dynamic lunge position. A mixed-effects analysis of variance (ANOVA) was used for examining hip extension data. The results show that foam rolling can be use to increase hip extension range of motion prior to physical activity.

Purpose: Examination of the hip provides information regarding risk for pre-arthritic hip disorders, knee injuries, and low back pain. The purpose of this study was to report a hip screening examination of asymptomatic female soccer athletes and to test the hypothesis that these findings vary by competition experience. Methods: Asymptomatic females from a youth soccer club, a college, and a professional team were evaluated. Passive hip range of motion, hip abduction strength, and hip provocative tests were assessed. Data were compared for the grade/middle school, high school, college, and professional athletes. Results: One hundred and seventy-two athletes with a mean age of 16.7 ± 5 years (range 10-30) participated. Professional athletes had less flexion (HF) for both hips ( p < 0.0001) and less internal rotation (IR) for the preferred kicking leg ( p < 0.05) compared to all other groups. Grade/middle school athletes had more external rotation in both hips as compared to all other groups ( p < 0.0001). For the preferred kicking leg, collegiate athletes had less hip abduction strength as compared to other groups ( p < 0.01). Positive provocative hip tests were found in 22 % of all players and 36 % of the professionals. In professionals, a positive provocative test was associated with ipsilateral decreased HF ( p = 0.04). Conclusion: Asymptomatic elite female soccer athletes with the most competition experience had less bilateral hip flexion and preferred kicking leg IR than less-experienced athletes. Positive provocative hip tests were found in 22 % of athletes. Future studies are needed to show whether these findings link to risk for intra-articular hip or lumbar spine and knee disorders. Level of evidence: III. [ABSTRACT FROM AUTHOR]

Background: Sciatica is one of the most common painful and disabling conditions affecting about 40% of low back pain cases and 1.6% - 43% of adult population annually. Many conventional physiotherapeutic modalities have been used to manage sciatica but the effect of Nerve Flossing Technique (NFT), which is a cost effective treatment option in the management of acute sciatica is yet to be investigated. Aim: This study was therefore conducted to investigate the influence of NFT on acute sciatica symptoms and hip range of motion. Methods: A pretest-posttest control experimental design, involving 32 participants from two hospitals in Lagos state Nigeria, with acute sciatica were randomly assigned into two groups; Group A (Study Group) received NFT in addition to Conventional Physiotherapy and group B (Control Group) received only Conventional Physiotherapy. The outcome of the study was assessed using Numeric Pain Rating Scale (NPRS) and Passive Straight Leg Raise (PSLR). Results: The result of this study revealed that, both groups were found to have significant improvement in NPRS score (P<0.01) and PSLR value (P<0.01). However, the study group had significant (P<0.01) improvement in both outcome measures when compared to the control group. Conclusion: Nerve Flossing Technique reduced acute sciatica and improved hip range of motion hence, can be utilised in the treatment of patient with acute sciatica. [ABSTRACT FROM AUTHOR]

The article presents research which examined the association of hip range of motion with the movements of injured female professional tennis players. Topics covered include the importance of adequate hip range of motion to the energy transfer of players. Also mentioned is the impact of repetitive rotational stresses in the players' lower extremities on the injuries that they incur.

A high prevalence of femoral version abnormalities has been observed in hip pain patients, with impact on hip range of motion and muscle strength that should be elucidated. Cross-sectional study. Thirty-one patients with hip pain (16 men and 15 female) were subjected to Biplanar X-Rays to quantify femoral version using three-dimensional measurements. The 62 hips were divided into normal version (10–20°, n = 18), anteverted (>20°, n = 19), and retroverted (<10°, n = 25). Joint range of motion for flexion, internal rotation, and external rotation was assessed through digital goniometry. Maximal isometric hip strength (flexion, extension, internal rotation, external rotation at 0° and 30°, abduction, adduction) was evaluated through hand-held dynamometry. Hip rotation index was calculated as external rotation minus internal rotation. Anteverted hips had greater internal rotation, while retroverted hips had greater external rotation (p = 0.001). Anteverted hips were weaker than retroverted hips for external rotation at 30° (p < 0.001), abduction (p = 0.006) and adduction (p < 0.001), and weaker than normal version hips for extension (p = 0.018). All three groups had different rotation index: retroverted>normal>anteverted (p < 0.001). The ordinal logistic regression found higher values of rotation index with higher probability of being retroverted (common odds ratio = 1.20). There was a strong correlation between femoral version group and rotation index (r S = 0.76, p < 0.001). There was probability >70% of a hip being anteverted if the rotation index was <11°, and being retroverted if the index was >40°. Range of motion and muscle strength differed in hips with different femoral versions. The hip rotation index was a strong femoral version predictor. • Hip internal rotation range of motion is maximized in anteverted hip patients. • Hip external rotation range of motion is maximized in retroverted hip patients. • Femoral version abnormalities affected hip muscle strength. • Rotation index is a strong femoral version predictor. • Femoral version should be considered in decision making of patients with hip pain. [ABSTRACT FROM AUTHOR]

BACKGROUND/OBJECTIVE: Given the possible links between movement, fitness and injury, the goal of this study was to evaluate strength, endurance, and hip range of motion (ROM) (i.e. fitness); movement quality; and age in a population of firefighters. PARTICIPANTS: Male firefighters (n=282), all members of a major Canadian city fire department, volunteered to participate in this cross-sectional study. METHODS: Torso endurance, grip strength, pull-ups, hip ROM, movement quality (sum of 7 movement tasks graded on a 0-3 scale), age, body mass, height, body mass index, and hip and waist circumference were assessed in 282 Firefighters. Relationships between variables were evaluated and compared to relevant populations (i.e. police officers, other firefighters, athletes, students and healthy males). RESULTS: There was no relationship between age and fitness or movement quality. Compared to other populations, our firefighter population had poorer torso endurance but similar grip strength. Larger body mass, waist circumference and hip width were correlated (p< 0.01) with poorer Total Movement Score. Back extensor endurance (Biering-Sorensen test) was found to have the strongest relationship with Total Movement Score in comparison to all other tests. Notably, the extensor endurance and pull-ups were related to five of nine tasks each. The magnitude of hip ROM asymmetry related only to the stand-sit-stand movement test. In general, correlations between variables were relatively low, suggesting that most of these variables are independent and/or unrelated to one another. CONCLUSIONS: Movement quality is not strongly correlated with traditionally utilized markers of fitness, nor is movement linked to age. This would imply that training should include movement competency components together with traditional fitness objectives. [ABSTRACT FROM AUTHOR]

Abstract: Primary total hip arthroplasties were performed in 70 hips for the treatment of Crowe type IV developmental dysplasia of the hip. The patients were subdivided into 2 groups with or without iliofemoral osteoarthritis. Leg length change was measured radiographically. Preoperative hip motion was reviewed from medical records and defined as either higher or lower motion groups. The leg length change in patients without iliofemoral osteoarthritis was significantly greater than that in patients with iliofemoral osteoarthritis, and the higher hip motion group had greater leg length change in total hip arthroplasty than the lower motion group. The current study identifies several features that might help predict leg length change during the preoperative planning of total hip arthroplasty for Crowe type IV developmental hip dysplasia. [Copyright &y& Elsevier]

Introduction: The role of the pelvic area in sagittal balance is evident for spinal surgeons, but the influence of the coxofemoral joint is underestimated and inadequately explained by conventional imagery. Comprehensive analysis of the pelvic and subpelvic sectors as part of the sagittal, frontal and cross-sectional balance of the trunk sheds new light on some spinal diseases and their relation to the pelvis. Methods: This analysis, based on innovative radiologic methods as the EOS technology but also on a new look at conventional imaging makes it possible to better analyze standing lateral images and seated images. Results: Disturbances can come from atypical morphotypes or from unusual postures as in aging spine. The measurement of available extension and the concept of available flexion provide new information regarding individual's adaptation to the imbalance induced by disorders of the spine or lower limbs. Conclusion: A comprehensive assessment of each patient and in particular of the complex comprising the spine and the pelvis, is essential for understanding each individual's adaptation to the imbalance induced by disorders of the spine or lower limbs. [ABSTRACT FROM AUTHOR]

Abstract: Previous comparisons of hip range of motion (ROM) after THA and surface replacement arthroplasty (SRA) are inconclusive due to the lack of soft tissue considerations and dissimilar control groups. The normal ROMs of 8 intact cadaveric hips were determined by placing specimens in 6 discrete, predefined positions of rotation at a standard torque. In each position, the limiting factor of ROM, either bony impingement or soft tissue restriction, could be determined. Total hip arthroplasty and SRA components were virtually implanted, and ROM until impingement was determined. With a THA, the ROM was comparable to that of the intact hip. With an SRA, flexion (111° ± 13°) was less than for the intact hip (131° ± 6°). Surface replacement arthroplasty, but not THA, significantly decreases the ROM compared to intact hips. [Copyright &y& Elsevier]

This is the first study to report on hip range of motion (ROM) among active prosthesis users, when wearing and not wearing a trans-femoral socket prosthesis and to compare with individuals rehabilitated with an osseointegrated bone-anchored prosthesis. In addition, discomfort when sitting with the prosthesis is reported in both groups. The study group all had a non-vascular amputation and were divided into those supplied with a socket prosthesis (S group) (n = 43, mean age 51 years, 74% men) or a bone-anchored prosthesis (OI group) (n = 20, mean age 46 years, 75% men). Active hip ROM was measured with a goniometer, and self-reported problems with discomfort when sitting were recorded. The hip motion decreased in all directions when wearing the socket prosthesis compared to without it (P < 0.001 for all directions), and 37% of the subjects had less than 90 degrees of hip flexion when wearing their prosthesis. Discomfort when sitting was reported among 44% (n = 19) in the S group and was more common among individuals with less than 90 degrees of hip flexion motion (P= 0.025). In the OI group, no restriction in hip motion was measured with the prosthesis, and no subject had less than 90 degrees of flexion and 5% (n = 1) reported discomfort when sitting. This study shows that a trans-femoral prosthetic socket significantly reduces the ROM of the hip and that discomfort when sitting is common among individuals wearing such prostheses. Further, the study confirms that individuals using a bone-anchored prosthesis have no restricted hip motion with the prosthesis and report very few problems with discomfort when sitting. [ABSTRACT FROM AUTHOR]

Describes the clinical management of a patient with sacroiliac joint dysfunction (SJD) and a concomitant asymmetrical hip-joint rotation range of motion. Case history; Patient evaluation; Plan of care design; Components of physical therapy for the patient; Relationship between SJD and asymmetrical hip joint rotation range of motion.

This study investigated the relationship between hip extensor (HE) strength to contralateral and ipsilateral hip flexor muscle length. Bilateral hip extension range of motion (ROM) was evaluated using the modified Thomas test using a hand-held goniometer in seventeen males (26 ± 7 yrs, 174.9 ± 6.72 cm, 79.4 ± 7.9 kg) and twenty-seven females (24 ± 2 yrs, 162.7 ± 6.40 cm, 67.2 ± 13.1 kg). Participants were classified as: a) restricted hip flexors (hip extension ROM > 6° from horizontal), b) neither restricted nor normal hip flexors (hip extension ROM between 0° to 6° from horizontal), and c) normal hip flexors (hip extension ROM < 0° from horizontal). Peak isometric HE force was obtained via a Biodex dynamometer where maximum voluntary contraction (MVC) was determined. Correlations were used to determine the relationship between flexor length to contralateral and ipsilateral HE relative strength. A One-way ANOVA was used to examine HE relative strength in relation to hip flexor length classified as restricted vs neither vs normal. There were no correlations between right hip flexor length and contralateral HE strength (r = -0.228, p = 0.137), right hip flexor length and ipsilateral HE strength (r = -0.241, p = 0.115), left hip flexor length and contralateral HE strength (r = -0.193, p = 0.210), and left hip flexor length and ipsilateral HE strength (r = -0.111, p = 0.472). The One-way ANOVA revealed no significant differences between the groups for the most restricted hip flexor and contralateral HE relative strength (p = 0.179) nor for the most restricted hip flexor and ipsilateral HE relative strength (p = 0.670). No significant relationships were found between HE strength and contralateral or ipsilateral hip flexor length. Although it is commonly suggested that practitioners address hip flexor length to assist with improving gluteal muscle strength, the results of this study do not validate this clinical practice. Despite the results indicating no correlations, practitioners are encouraged to address these impairments from both a functional and performance based perspective. [ABSTRACT FROM AUTHOR]

Children with early Perthes’ disease and clinical loss of motion are commonly noted to have normal or almost normal hip range of motion (ROM) when examined under anesthesia (EUA). Despite anecdotal comments about this observation, no series has documented these findings. The lack of such data led to this study. Consecutive patients with unilateral Herring class B or C Perthes’ disease in mid to late Waldenstrom’s fragmentation stages who failed a non-operative course of hip motion restoration had hip range of motion (ROM) documented pre-operatively and intra-operatively by a single, experienced pediatric orthopedic surgeon. The opposite normal hip’s ROM was used as the control. Joint congruity was assessed arthrographically. Twenty-seven patients, 6–10 years old (average 7.9 years) with early Perthes’ disease were reviewed. Twenty-one of 27 patients (77.7%) had full or almost full hip ROM of the involved side when examined under anesthesia (EUA). Six patients (22.3%) had limited abduction (<50 degrees) and underwent an adductor tenotomy that normalized hip ROM. Five of these six patients were older than 8 years. Intra-operative arthrography did not demonstrate lack of containment, hinge abduction or joint incongruity. Loss of hip ROM in this series of patients with early Perthes’ disease without intra-articular incongruity was due to pain and muscle spasm which were obviated by anesthesia, demonstrating essentially normal hip ROM in the majority of patients. Pre-operative bed rest and traction was not required to restore ROM in this group of patients. [ABSTRACT FROM AUTHOR]

Objective. Examine the influence of knee positions and gender on the Ober test for the length of the iliotibial band.Design. A cross-sectional comparative repeated measures design.Background. The Ober test is in widespread use, yet the influence of knee positions and gender on the test has not been reported. Such information is needed to help clarify test results.Methods. The Ober test was administered with the knee flexed to 90° and extended to 0° to the right lower limb of 26 women and 23 men. The limb was lowered from abduction and the end point of hip abduction (positive angle) or hip adduction (negative angle) was measured in relation to neutral.Results. The hip adduction movement was restricted more with the knee flexed than with the knee extended for both genders (P<0.009). With the knee flexed the mean hip abduction angle was less for men (+4°) than for women (+6°) (P<0.001), and with the knee extended the mean hip adduction angle was greater for men (−9°) than for women (−4°) (P<0.001).Conclusion. The Ober test with the knee flexed limited hip adduction more than with the knee extended for both men and women, and women had greater limitations than men.RelevanceThe Ober test with the knee flexed and with the knee extended yielded different results and may be considered different tests. Normal Ober test values for the two knee positions should be defined separately for men and women in order to understand how deviations from normal are related to pathologies. [Copyright &y& Elsevier]

Context: Compared to shoulder and elbow functions, the hip functional characteristics of baseball pitchers have not been fully investigated. Therefore, little is known about the relationship between hip function and pitching performance., Objective: The purpose of this study was to evaluate the characteristics of hip flexibility and strength, focusing on their influences on the ball velocity in baseball pitchers., Design: Descriptive laboratory study., Setting: Laboratory and university baseball facility., Participants: Twenty-three college baseball pitchers., Interventions: Passive hip range of motion (ROM) and isometric hip muscle strength were bilaterally measured. The pitchers threw 20 fastballs at an official pitching distance., Main Outcome Measures: Bilateral hip ROM and strength in flexion, extension, abduction, adduction, and external and internal rotation; the maximal ball velocity., Results: The pivot side showed smaller hip external rotation ROM (P < .01), larger hip internal rotation ROM (P = .03), and greater hip adduction strength (P = .03) than the stride side. The hip extension ROM on the stride side had a negative correlation with the maximal ball velocity (r = -.58, P < .01). The maximal ball velocity (135.3 [4.1] km/h) positively correlated with the hip extension (r = .59, P < .01), flexion (r = .57, P < .01), abduction (r = .55, P < .01), and adduction (r = .55, P < .01) strength on the pivot leg, and the hip flexion (r = .53, P = .01), abduction (r = .67, P < .01), and adduction (r = .46, P = .03) strength on the stride leg., Conclusions: These findings suggest that baseball pitchers do not have marked side-to-side differences in hip flexibility and strength, and that an important fitness factor for increasing ball velocity is not the hip flexibility but the hip muscle strength of both legs.

Background: Dance involves movements of complexity and physical intensity which result in stress on the body. As a consequence, dancers are at risk of injury which can impact on their well-being. Screening tools are used for injury prevention to identify those dancers at risk of injury. The aim of this study was to investigate which screening tools can predict injury in dancers, encompassing all dance genres, levels and ages., Methods: An electronic search of seven databases from their inception to December 2017 was conducted. The databases were the Allied and Complementary Medicine Database (AMED), CINAHL, eBOOK Collection (EBSCOhost), MEDLINE, Cochrane Database of Systematic Reviews, SPORTDiscus and PEDro: the Physiotherapy Evidence Base. The following search terms were used: (i) Dance AND injury AND Screening, (ii) Screening AND dance and (iii) Musculoskeletal AND Screening AND Dance. Studies were assessed using a 20-point scoring tool, and eligible studies were included in a meta-analysis., Results: The mean methodological quality score was 12.2 points. Injured dancers had a significantly higher compensated turnout range of motion than non-injured dancers: pooled mean difference of compensated turnout (23.29°; 95% CI 14.85-31.73; P < 0.00001; I 2  = 0%). Injured dancers had significantly greater functional turnout range of motion when compared to non-injured dancers: pooled mean difference of functional turnout (14.08°; 95% CI 7.09-21.07; P < 0.0001; I 2  = 0%). There also some evidence for use of hip range of motion as a predictor of dance injury., Conclusions: Some evidence exists for the potential use of dance-specific positions as a predictor of injury. A number of studies were limited by a lack of prospective injury design, injury definition and self-reporting of injury.