Physical Therapy Department, Santa Casa of São Paulo, São Paulo, Brazil; Trata Institute, Knee and Hip Rehabilitation, São Paulo, Brazil.
Physical Therapy Department, Santa Casa of São Paulo, São Paulo, Brazil.
Musculoskelet Sci Pract. 2019 Dec;44:102051. doi: 10.1016/j.msksp.2019.102051. Epub 2019 Aug 22.
Manual therapy have been used as a disinhibitory intervention to increase muscle activation before performing functional tasks that are limited by weakness. Knee injuries are commonly associated with weakness in quadriceps and gluteus. Currently, there is no evidence to support anecdotal experience that a hip distraction mobilization improves muscle performance in subjects with knee injuries and lower extremity weakness.
To determine if a hip distraction mobilization would result in an immediate change of maximal force output of the quadriceps and gluteus.
Non-controlled observational pre-post design.
Forty individuals with knee pathology were included. Subjects underwent quadriceps, gluteus maximus, and gluteus medius muscle strength assessment before a single hip distraction of the symptomatic side. An immediate re-assessment of muscle strength of both symptomatic and asymptomatic sides followed the mobilization.
/findings: Comparing pre-to post-mobilization strength on the symptomatic side, a significant increase was found with the gluteus maximus (average change = 2.0 kg [95%CI 0.6-3.4]; p < 0.01) but not gluteus medius (0.2 kg [-0.7-1.0]; p = 0.71) or quadriceps (0.1 kg [-1.4-1.7]; p = 0.86). When comparing the strength on the symptomatic side in subjects with weakness greater than the MDD (0.7-2.9 kg), a significant increase was again found for gluteus maximus (4.7 kg [2.6-6.8]; p < 0.01) but not for gluteus medius (0.2 kg [-1.0-1.4]; p = 0.71) or quadriceps (1.6 kg [-0.7-3.9]; p = 0.15).
A single hip distraction resulted in a significant increase in gluteus maximus strength but did not produce a change in gluteus medius or quadriceps strength in subjects with knee injuries.
手动疗法已被用作抑制性干预措施，以在进行因虚弱而受限的功能任务之前增加肌肉激活。膝关节损伤通常与股四头肌和臀肌无力有关。目前，没有证据支持这样的说法，即髋关节牵伸松动术可以改善膝关节损伤和下肢无力患者的肌肉表现。
确定髋关节牵伸松动术是否会导致股四头肌和臀肌的最大力输出立即发生变化。
非对照观察性前后设计。
共纳入 40 名膝关节疾病患者。患者在患侧髋关节牵伸前接受股四头肌、臀大肌和臀中肌肌力评估。牵伸后立即对患侧和健侧的肌肉力量进行重新评估。
与松动前相比，患侧的肌肉力量明显增加，臀大肌增加了 2.0kg（95%CI 0.6-3.4；p<0.01），但臀中肌（0.2kg[-0.7-1.0]；p=0.71）或股四头肌（0.1kg[-1.4-1.7]；p=0.86）没有明显变化。当比较患侧肌肉力量时，在肌力减弱大于 MDD（0.7-2.9kg）的患者中，臀大肌再次显著增加（4.7kg[2.6-6.8]；p<0.01），但臀中肌（0.2kg[-1.0-1.4]；p=0.71）或股四头肌（1.6kg[-0.7-3.9]；p=0.15）没有明显变化。
单次髋关节牵伸可显著增加臀大肌力量，但不能改变膝关节损伤患者的臀中肌或股四头肌力量。
