Department of Physiatrist and Nursery, Faculty of Heath Sciences, University of Zaragoza, Zaragoza, Spain.
Faculty of Medicine and Health Sciences, Universitat International de Catalunya, Barcelona, Spain; Fundació Institut Universitari per a La Recerca a L'Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Barcelona, Spain.
Musculoskelet Sci Pract. 2020 Jun;47:102148. doi: 10.1016/j.msksp.2020.102148. Epub 2020 Mar 6.
Several studies have suggested that the changes in elasticity of the joint capsule and surrounding muscles during a hip long-axis distraction mobilization (LADM) could explain the pain-relieving and mobility-improving effects of the technique.
To compare the strain on the inferior ilio-femoral ligament and psoas muscle when applying three different magnitudes of force during LADM.
Repeated measures controlled laboratory cadaveric study.
Eleven hip joints were mobilized from six fresh-frozen cadavers (mean age, 73.4 ± 5.7 years). Three magnitudes of force (low, medium and high) were applied during a hip LADM in open-packed position according to grades of joint mobilization. Strain on the inferior ilio-femoral ligament and psoas muscle were measured with strain gauges. The magnitude of the force applied during LADM was recorded.
Strain on the inferior ilio-femoral ligament during a high-force LADM was significantly higher than strain on the inferior ilio-femoral ligament during low (p < 0.001) and medium-force LADM (p < 0.001). The strain on the inferior ilio-femoral ligament during a medium-force LADM was significantly higher than during a low-force LADM (p = 0.004). No changes in strain on psoas muscle were observed. The magnitude of force applied during LADM showed a significant progressive increase from low to high-force LADM.
The different magnitudes of forces applied during LADM produce different strains on the inferior ilio-femoral ligament but not on the psoas muscle. The strain on the inferior ilio-femoral ligament during LADM depends on the magnitude of the mobilization force.
多项研究表明，髋关节长轴牵伸松动术（LADM）过程中关节囊和周围肌肉弹性的变化可以解释该技术的止痛和改善活动度的效果。
比较 LADM 中施加三种不同力大小时对下髂股韧带和腰大肌的应变。
重复测量控制的实验室尸体研究。
从 6 个新鲜冷冻尸体（平均年龄，73.4 ± 5.7 岁）中移动了 11 个髋关节。根据关节松动度分级，在打开包装的位置对髋关节进行 LADM 时施加三种力大小（低、中、高）。使用应变片测量下髂股韧带和腰大肌的应变。记录 LADM 过程中施加的力的大小。
高力 LADM 时下髂股韧带的应变明显高于低力（p < 0.001）和中力 LADM（p < 0.001）时的应变。中力 LADM 时下髂股韧带的应变明显高于低力 LADM（p = 0.004）。腰大肌的应变没有变化。LADM 过程中施加的力的大小从低力到高力呈显著递增趋势。
LADM 中施加的不同力大小会在下髂股韧带上产生不同的应变，但不会在腰大肌上产生应变。LADM 时下髂股韧带的应变取决于松动力的大小。
