Background

Compensatory mechanisms for hip pain, pathology, and weakness include excessive trunk lean towards the stance limb, counteracting pelvic drop to maintain stability during single leg stance. Trunk lean shifts the center of mass towards the hip joint center to decrease the moment arm and reduce hip abductor demand. The purpose of this study was to evaluate whether adolescent patients with symptomatic hip pain demonstrate excessive trunk lean and the effect on the hip abductor moment impulse.

Methods

Self-selected speed walking data collected through an approved study were reviewed on pre-operative patients clinically diagnosed with a hip deformity. Instrumented motion analysis was performed to analyze trunk kinematics and the hip abductor moment impulse.

Findings

There was a weak, but significant correlation between hip abductor moment impulse and trunk lean. Patients diagnosed with Acetabular Dysplasia demonstrated an increased trunk lean and a decreased hip abductor moment impulse (r = − 0.311, p = 0.001). Of those who presented with excessive trunk lean, 62% of these patients had a normal hip abductor moment impulse. There was no correlation between hip abductor moment impulse and hip abductor strength.

Interpretation

Excessive trunk lean was not seen uniformly across adolescent patients with symptomatic hip deformities, despite pain being reported in 80% of patients. Furthermore, a majority of those that presented with excessive trunk lean did not present with a reduced moment, suggesting that although the amount of lean was greater than normal, it was not enough to significantly reduce the demand on the hip musculature.

中文翻译：

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行走前髋关节病理学患者冠状干运动与髋外展力矩冲动的关系

背景

髋关节疼痛，病理和虚弱的补偿机制包括：躯干过度向肢体倾斜，抵消骨盆下降以保持单腿站立时的稳定性。躯干倾斜将重心移向髋关节中心，以减少弯矩臂并减少髋关节外展肌的需求。这项研究的目的是评估青少年症状性髋关节疼痛患者是否表现出过度的躯干倾斜以及对髋关节外展力矩的影响。

方法

对通过临床研究确诊为髋关节畸形的术前患者，回顾了通过一项获批准的研究收集的自行选择的步行数据。进行了仪器化的运动分析，以分析躯干运动学和髋外展力矩冲动。

发现

髋关节外展力矩与躯干倾斜之间存在微弱但显着的相关性。被诊断为髋臼发育不良的患者表现出躯干倾斜增加和髋外展力矩冲动降低（r  = − 0.311，p  = 0.001）。在躯干过度倾斜的患者中，这些患者中有62％的髋关节外展力矩正常。髋关节外展力矩与髋外展肌力量之间没有相关性。

解释

尽管有80％的患者报告疼痛，但在有症状的髋关节畸形的青少年患者中均未见过均匀的躯干过度倾斜。此外，大多数那些躯干过度倾斜的人的力矩没有减少，这表明尽管倾斜量比正常人大，但这不足以显着减少对臀部肌肉组织的需求。