Highlights
- •Impaired gluteal muscle function may affect femoroacetabular impingement syndrome.
- •Patient-specific finite element models were derived from computed tomography scans.
- •Non-cued and cued gluteal activation deep squat tasks were performed and compared.
- •Electromyography-driven hip models considered patient movement and muscle activity.
- •Increased gluteal muscle activity can alter hip kinematics to minimize impingement.
Abstract
Background
Femoroacetabular impingement syndrome is a motion-related clinical disorder resulting
from abnormal hip joint morphology. Mechanical impingement, in which the aspherical
femoral head (cam morphology) abuts with the acetabular rim, is created with simultaneous
hip flexion, internal rotation, and adduction. Impaired function of the gluteal muscles
may be contributory to femoroacetabular impingement syndrome progression. The purpose
of this study was to assess the influence of gluteal muscle recruitment on acetabular
contact pressure during squatting in persons with cam femoroacetabular impingement
syndrome.
Methods
Eight individuals (4 males, 4 females) with a diagnosis of cam femoroacetabular impingement
syndrome underwent CT imaging of the pelvis and proximal femora, and a biomechanical
assessment of squatting (kinematics, kinetics, and electromyography). Two maximal
depth bodyweight squat conditions were evaluated: 1) non-cued squatting; and 2) cued
gluteal activation squatting. Utilizing subject-specific electromyography-driven hip
and finite element modeling approaches, hip muscle activation, kinematics, bone-on-bone
contact forces, and peak acetabular contact pressure were compared between squat conditions.
Findings
Modest increases in gluteus maximus (7% MVIC, P < 0.0001) and medius (6% MVIC, P = 0.009) activation were able to reduce hip internal rotation on average 5° (P = 0.024), and in doing so reduced acetabular contact pressure by 32% (P = 0.023). Reductions in acetabular contact pressure occurred despite no change in hip
abduction and increased bone-on-bone contact forces occurring in the cued gluteal
activation condition.
Interpretation
Our findings highlight the importance of gluteal activation in minimizing mechanical
impingement and provide a foundation for interventions aimed at preventing the development
and progression of femoroacetabular impingement syndrome.
Keywords
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Article info
Publication history
Published online: December 01, 2022
Accepted:
November 29,
2022
Received:
February 27,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
