Advertisement

Differences in hip torque ratios between individuals with femoroacetabular impingement syndrome and asymptomatic individuals: A cross-sectional study

      Highlights

      • Hip transverse plane muscle imbalance is absent in femoroacetabular impingement.
      • Hip torque ratios can discriminate a severe femoroacetabular impingement state.
      • Greater abductor relative to adductor torque in severe femoroacetabular impingement.

      Abstract

      Background

      Hip torque ratios are considered a useful measure for patients with hip pain. However, evidence regarding this measure for patients with femoroacetabular impingement syndrome is scarce. The primary aim of this study was to compare hip external-internal rotation and abduction-adduction torque ratios between patients with femoroacetabular impingement syndrome and asymptomatic individuals. The secondary aim was to compare hip torque ratios between the asymptomatic group and femoroacetabular impingement syndrome patients grouped according to the severity of symptoms and functional limitations.

      Methods

      Hip abduction-adduction and external-internal rotation torque ratios of 134 individuals with femoroacetabular impingement syndrome and 134 asymptomatic matched controls was assessed through isokinetic testing. Severity of symptoms and functional limitations was assessed through the iHOT-33. Mann Whitney U and Kruskall-Wallis tests were used to compare hip torque ratios between asymptomatic individuals and patients with femoroacetabular impingement syndrome and to patients with femoroacetabular impingement syndrome with different severities of symptoms and functional limitations.

      Findings

      No differences were identified in hip abduction-adduction (U = 7659.5, p = 0.192) and external-internal rotation (U = 8787.5, p = 0.764) torque ratios between patients with femoroacetabular impingement syndrome and asymptomatic individuals. Hip abduction-adduction torque ratio was higher (p = 0.0127) in patients with a severe state (median = 1.80, IQR = 0.61) when compared to asymptomatic individuals (median = 1.52, IQR = 0.45) (moderate effect size, r = 0.45).

      Interpretation

      Patients with severe symptoms and functional limitations related to FAI syndrome presented greater hip abduction-adduction torque ratio than asymptomatic individuals, suggesting a decreased adduction torque capacity relative to abduction torque in this subgroup of femoroacetabular impingement.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Biomechanics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Belhaj K.
        • Meftah S.
        • Mahir L.
        • Lmidmani F.
        • Elfatimi A.
        Isokinetic imbalance of adductor–abductor hip muscles in professional soccer players with chronic adductor-related groin pain.
        Eur. J. Sport Sci. 2016; 16: 1226-1231https://doi.org/10.1080/17461391.2016.1164248
        • Casartelli N.C.
        • Maffiuletti N.A.
        • Item-Glatthorn J.F.
        • Staehli S.
        • Bizzini M.
        • Impellizzeri F.M.
        • Leunig M.
        Hip muscle weakness in patients with symptomatic femoroacetabular impingement.
        Osteoarthr. Cartil. 2011; 19: 816-821https://doi.org/10.1016/j.joca.2011.04.001
        • de Castro M.P.
        • Ruschel C.
        • Santos G.M.
        • Ferreira T.
        • Pierri C.A.A.
        • Roesler H.
        Isokinetic hip muscle strength: a systematic review of normative data.
        Sport. Biomech. 2020; 19: 26-54https://doi.org/10.1080/14763141.2018.1464594
        • Diamond L.E.
        • Wrigley T.V.
        • Hinman R.S.
        • Hodges P.W.
        • O’Donnell J.
        • Takla A.
        • Bennell K.L.
        Isometric and isokinetic hip strength and agonist/antagonist ratios in symptomatic femoroacetabular impingement.
        J. Sci. Med. Sport. 2016; 19: 696-701https://doi.org/10.1016/j.jsams.2015.10.002
        • Drigny J.
        • Gauthier A.
        • Reboursière E.
        • Guermont H.
        • Gremeaux V.
        • Edouard P.
        Shoulder muscle imbalance as a risk for shoulder injury in elite adolescent swimmers: a prospective study.
        J. Human Kinet. 2020; 75: 103-113https://doi.org/10.2478/hukin-2020-0041
        • Edouard P.
        • Degache F.
        • Oullion R.
        • Plessis J.Y.
        • Gleizes-Cervera S.
        • Calmels P.
        Shoulder strength imbalances as injury risk in handball.
        Int. J. Sports Med. 2013; 34: 654-660https://doi.org/10.1055/s-0032-1312587
        • Freke M.D.
        • Kemp J.
        • Svege I.
        • Risberg M.A.
        • Semciw A.
        • Crossley K.M.
        Physical impairments in symptomatic femoroacetabular impingement: a systematic review of the evidence.
        Br. J. Sports Med. 2016; 50: 1180https://doi.org/10.1136/bjsports-2016-096152
        • Freke M.
        • Kemp J.
        • Semciw A.
        • Sims K.
        • Russell T.
        • Singh P.
        • Crossley K.
        Hip strength and range of movement are associated with dynamic postural control performance in individuals scheduled for arthroscopic hip surgery.
        J. Orthop. Sports Phys. Ther. 2018; 48: 280-288https://doi.org/10.2519/jospt.2018.7946
        • Freke M.
        • Kemp J.
        • Crossley K.
        • Sims K.
        • Russell T.
        • Semciw A.
        Strength and range of movement deficits are associated with symptom severity in people scheduled for hip arthroscopy.
        Eur. J. Pain (UK). 2019; 23: 1083-1090https://doi.org/10.1002/ejp.1371
        • Fritz C.O.
        • Morris P.E.
        • Richler J.J.
        Effect size estimates: current use, calculations, and interpretation.
        J. Exp. Psychol. Gen. 2012; 141: 2-18https://doi.org/10.1037/a0024338
        • Gomes D.
        • Ribeiro D.C.
        • Canella R.P.
        • Ferreira T.
        • da Costa G.V.
        • Okubo R.
        • de Castro M.P.
        Association between severity of hip chondrolabral injuries, dynamic hip muscle strength and quality of life: a cross-sectional study in patients with femoroacetabular impingement syndrome scheduled for hip arthroscopy.
        Clin. Biomech. 2021; 84105348https://doi.org/10.1016/j.clinbiomech.2021.105348
        • Gomes D.
        • Ribeiro D.C.
        • Ferreira T.
        • da Costa G.V.
        • Canella R.P.
        • de Castro M.P.
        Knee and hip dynamic muscle strength in individuals with femoroacetabular impingement syndrome scheduled for hip arthroscopy: a case-control study.
        Clin. Biomech. 2022; 93105584https://doi.org/10.1016/j.clinbiomech.2022.105584
        • Griffin D.R.
        • Dickenson E.J.
        • O’Donnell J.
        • Agricola R.
        • Awan T.
        • Beck M.
        • Clohisy J.C.
        • Dijkstra H.P.
        • Falvey E.
        • Gimpel M.
        • Hinman R.S.
        • Hölmich P.
        • Kassarjian A.
        • Martin H.D.
        • Martin R.
        • Mather R.C.
        • Philippon M.J.
        • Reiman M.P.
        • Takla A.
        • Bennell K.L.
        The Warwick agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement.
        Br. J. Sports Med. 2016; 50: 1169-1176https://doi.org/10.1136/bjsports-2016-096743
        • Heerey J.
        • Risberg M.A.
        • Magnus J.
        • Moksnes H.
        • Ødegaard T.
        • Crossley K.
        • Kemp J.L.
        Impairment-based rehabilitation following HIP arthroscopy: postoperative protocol for the HIP arthroscopy international randomized controlled trial.
        J. Orthop. Sports Phys. Ther. 2018; 48: 336-342https://doi.org/10.2519/jospt.2018.8002
        • Ishøi L.
        • Thorborg K.
        • Kemp J.L.
        • Reiman M.P.
        • Hölmich P.
        Maximal hip muscle strength and rate of torque development 6–30 months after hip arthroscopy for femoroacetabular impingement syndrome: a cross-sectional study.
        J. Sci. Med. Sport. 2021; (xxxx)https://doi.org/10.1016/j.jsams.2021.05.006
        • Kemp J.L.
        • Collins N.J.
        • Roos E.M.
        • Crossley K.M.
        Psychometric properties of patient-reported outcome measures for hip arthroscopic surgery.
        Am. J. Sports Med. 2013; 41: 2065-2073https://doi.org/10.1177/0363546513494173
        • Kemp J.L.
        • Schache A.G.
        • Makdissi M.
        • Sims K.J.
        • Crossley K.M.
        Greater understanding of normal hip physical function may guide clinicians in providing targeted rehabilitation programmes.
        J. Sci. Med. Sport. 2013; 16: 292-296https://doi.org/10.1016/j.jsams.2012.11.887
        • Kemp J.L.
        • Johnston R.T.R.
        • Coburn S.L.
        • Jones D.M.
        • Schache A.G.
        • Mentiplay B.F.
        • King M.G.
        • Scholes M.J.
        • De Oliveira Silva D.
        • Smith A.
        • McPhail S.M.
        • Crossley K.M.
        Physiotherapist-led treatment for femoroacetabular impingement syndrome (the PhysioFIRST study): a protocol for a participant and assessor-blinded randomised controlled trial.
        BMJ Open. 2021; 11e041742https://doi.org/10.1136/bmjopen-2020-041742
        • Kierkegaard S.
        • Mechlenburg I.
        • Lund B.
        • Søballe K.
        • Dalgas U.
        Impaired hip muscle strength in patients with femoroacetabular impingement syndrome.
        J. Sci. Med. Sport. 2017; 20: 1062-1067https://doi.org/10.1016/j.jsams.2017.05.008
        • Mohtadi N.G.H.
        • Griffin D.R.
        • Pedersen M.E.
        • Chan D.
        • Safran M.R.
        • Parsons N.
        • Sekiya J.K.
        • Kelly B.T.
        • Werle J.R.
        • Leunig M.
        • McCarthy J.C.
        • Martin H.D.
        • Byrd J.W.T.
        • Philippon M.J.
        • Martin R.L.
        • Guanche C.A.
        • Clohisy J.C.
        • Sampson T.G.
        • Kocher M.S.
        • Larson C.M.
        The development and validation of a self-administered quality-of-life outcome measure for young, active patients with symptomatic hip disease: the international hip outcome tool (iHOT-33).
        Arthroscopy. 2012; 28: 595-610.e1https://doi.org/10.1016/j.arthro.2012.03.013
        • Monajati A.
        • Larumbe-Zabala E.
        • Goss-Sampson M.
        • Naclerio Naclerio F.
        The effectiveness of injury prevention programs to modify risk factors for non-contact anterior cruciate ligament and hamstring injuries in uninjured team sports athletes: a systematic review.
        PLoS One. 2016; 11: 1-15https://doi.org/10.1371/journal.pone.0155272
        • Nepple J.J.
        • Riggs C.N.
        • Ross J.R.
        • Clohisy J.C.
        Clinical presentation and disease characteristics of femoroacetabular impingement are sex-dependent.
        J. Bone Joint Surg. 2014; 96: 1683-1689https://doi.org/10.2106/JBJS.M.01320
        • Polesello G.C.
        • Godoy G.F.
        • De Castro Trindade C.A.
        • De Queiroz M.C.
        • Honda E.
        • Ono N.K.
        Translation and cross-cultural adaptation of the modified hip outcome tool (mhot) into portuguese.
        Acta Ortoped. Brasil. 2012; 20: 88-92https://doi.org/10.1590/S1413-78522012000200006
      1. R Core Team. (2016). R: A Language and Environment for Statistical Computing. Vienna, Austria. Retrieved from https://www.R-project.org/.

        • Reimer L.C.U.
        • Kierkegaard S.
        • Mechlenburg I.
        • Jacobsen J.S.
        Does daily physical activity differ between patients with Femoroacetabular impingement syndrome and patients with hip dysplasia? A cross-sectional study in 157 patients and 60 healthy volunteers.
        Int. J. Sports Phys. Ther. 2021; 16: 1084-1092https://doi.org/10.26603/001c.25523
        • Rodriguez R.
        Measuring the hip adductor to abductor strength ratio in ice hockey and soccer players: a critically appraised aopic.
        J. Sport Rehabil. 2020; 29: 116-121https://doi.org/10.1123/jsr.2018-0250
        • Rosenthal R.
        Parametric measures of effect size.
        in: The Handbook of Research Synthesis. Russell Sage Foundation, 1994: 231-244
        • Thorborg K.
        • Serner A.
        • Petersen J.
        • Moller Madsen T.
        • Magnusson P.
        • Hölmich P.
        Hip adduction and abduction strength profiles in elite soccer players: implications for clinical evaluation of hip adductor muscle recovery after injury.
        Am. J. Sports Med. 2011; 39: 121-126https://doi.org/10.1177/0363546510378081
        • Tyler T.F.
        • Nicholas S.J.
        • Campbell R.J.
        • McHugh M.P.
        The association of hip strength and flexibility with the incidence of adductor muscle strains in professional ice hockey players.
        Am. J. Sports Med. 2001; 29: 124-128https://doi.org/10.1177/03635465010290020301
        • Zimmerer A.
        • Ramoser A.
        • Streit M.
        • Janz V.
        • Sobau C.
        • Wassilew G.I.
        • Miehlke W.
        Osteoarthrosis, advanced age, and female sex are risk factors for inferior outcomes after hip arthroscopy and labral debridement for femoroacetabular impingement syndrome: case series with minimum 10-year follow-up.
        Arthroscopy. 2021; 37: 1822-1828.e1https://doi.org/10.1016/j.arthro.2021.01.024