Halliwell Carson, Rutherford Derek, Moreside Janice, Wong Ivan, Moyer Rebecca
School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, NS, Canada.
School of Biomedical Engineering, Faculty of Engineering, Dalhousie University, Halifax, NS, Canada.
J Sport Rehabil. 2024 Nov 12;34(4):353-360. doi: 10.1123/jsr.2024-0084. Print 2025 May 1.
Femoroacetabular impingement syndrome (FAIS) is a movement-related condition associated with pain and impaired function; yet the evidence for level ground walking hip biomechanics is limited and inconsistent. Challenging the hip with inclined walking for individuals with FAIS might be important for elucidating mechanically driven function loss and informing tailored rehabilitation. The purpose of this study was to determine the effects of progressive inclined walking on sagittal hip biomechanics and hip flexor and extensor activity in individuals with FAIS.
Cross-sectional.
Fourteen participants (7 individuals with FAIS and 7 asymptomatic individuals) underwent motion capture and electromyographic analysis during 3 treadmill walking conditions (0°/5°/10°). Statistical parametric mapping was used to compare the sagittal hip kinematic waveforms and hip flexor (rectus femoris) and extensor (gluteus maximus) waveforms between groups and walking conditions.
Hip flexion was significantly increased throughout the gait cycle in individuals with FAIS compared with asymptomatic individuals (P < .01) but was not dependent on incline. Rectus femoris activation was significantly increased throughout stance in individuals with FAIS compared with asymptomatic individuals (P < .01). Gluteus maximus activity significantly increased with progressive inclination in asymptomatic individuals (P < .01), with no significant change in activity for individuals with FAIS.
Hip biomechanics and muscle activity during inclined walking mirrored that of arthrogenic muscle inhibition, highlighted by a prominent flexor role and lack of hip extensor activity in individuals with FAIS. Future research investigating discordant activity between hip flexors and extensors during complex functional tasks may help identify rehabilitation targets.
股骨髋臼撞击综合征（FAIS）是一种与疼痛和功能受损相关的运动性疾病；然而，关于平地行走时髋关节生物力学的证据有限且不一致。对FAIS患者进行倾斜行走以挑战髋关节，可能对阐明机械驱动的功能丧失及指导个性化康复具有重要意义。本研究的目的是确定渐进性倾斜行走对FAIS患者矢状面髋关节生物力学以及髋关节屈肌和伸肌活动的影响。
横断面研究。
14名参与者（7名FAIS患者和7名无症状个体）在3种跑步机行走条件（0°/5°/10°）下接受了运动捕捉和肌电图分析。采用统计参数映射法比较两组之间以及不同行走条件下的矢状面髋关节运动学波形、髋关节屈肌（股直肌）和伸肌（臀大肌）波形。
与无症状个体相比，FAIS患者在整个步态周期中的髋关节屈曲显著增加（P <.01），但不依赖于坡度。与无症状个体相比，FAIS患者在整个站立期股直肌的激活显著增加（P <.01）。在无症状个体中，臀大肌活动随着坡度的增加而显著增加（P <.01），而FAIS患者的活动没有显著变化。
倾斜行走时的髋关节生物力学和肌肉活动反映了关节源性肌肉抑制的情况，其特点是FAIS患者中屈肌作用突出且缺乏髋关节伸肌活动。未来研究复杂功能任务期间髋关节屈肌和伸肌之间不协调活动，可能有助于确定康复目标。
