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Tensor Fascia Latae Muscle Structure and Activation in Individuals With Lower Limb Musculoskeletal Conditions: A Systematic Review and Meta-Analysis

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Abstract

Background

Dysfunction of the tensor fascia latae (TFL) muscle is often clinically implicated in many musculoskeletal disorders.

Objective

To systematically review the literature of the TFL muscle to determine whether there are differences in its structure and activation between individuals with and without lower limb musculoskeletal conditions.

Data sources

A comprehensive search in MEDLINE, EMBASE, CINHAL, and LILACS was undertaken from year of inception to 9 July 2019.

Eligibility criteria for selecting studies

Studies that directly investigated the structure or activity of the TFL muscle between individuals with a lower limb musculoskeletal condition and a pain-free control group.

Results

Seventeen studies were included (n = 556 participants), eight reporting structure and ten activation of the TFL muscle. Conditions included lateral hip pain, hip joint pathology, ACL injury, iliotibial band syndrome, and patellofemoral joint osteoarthritis. Meta-analysis identified with low confidence (p value = 0.07) a small tendency towards hypertrophy in the affected side of participants with hip joint diseases (SMD 0.37, 95% CI [− 0.02, 0.77]). Moderate effect sizes were found for a higher cross-sectional area of the TFL/sartorius ratio in abductor tendon tear (SMD 0.74; 95% CI [0.05, 1.43, p value = 0.04), and for a smaller body mass normalized TFL volume in patellofemoral joint osteoarthritis (SMD − 0.61; 95% CI [− 1.23, 0.00], p value = 0.05). Normalised electromyography (EMG) amplitude did not differ between groups for any condition, but when EMG was analysed as linear envelopes or synergies, some differences in pattern of TFL activation were observed between individuals with lateral hip pain and controls. Timing of TFL activation did not differ between individuals with knee conditions and controls.

Conclusions and implications

Common clinical assumptions of the role of TFL muscle in lower limb musculoskeletal conditions are not well investigated and poorly supported by current research. There are contradictory findings on the muscle size of TFL. Differing methodology in muscle activation studies precludes a clear interpretation for comparison between groups.

PROSPERO registration number

CRD42017076160.

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Authors and Affiliations

  1. The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, QLD, 4072, Australia

    Manuela Besomi, Liam Maclachlan, Rebecca Mellor, Bill Vicenzino & Paul W. Hodges

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  1. Manuela Besomi
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  2. Liam Maclachlan
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  3. Rebecca Mellor
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Correspondence to Paul W. Hodges.

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Funding

This research was funded by the National Health and Medical Research Council (NHMRC) of Australia (Program Grant: APP1091302). PWH is supported by an NHMRC Senior Principal Research Fellowship (APP1102905). MB is supported by the University of Queensland Research Training Scholarship.

Conflict of Interests

Manuela Besomi, Liam Maclachlan, Rebecca Mellor, Bill T. Vicenzino, and Paul W. Hodges declare that they have no conflict interest.

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All extracted data are available in the article.

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Besomi, M., Maclachlan, L., Mellor, R. et al. Tensor Fascia Latae Muscle Structure and Activation in Individuals With Lower Limb Musculoskeletal Conditions: A Systematic Review and Meta-Analysis. Sports Med 50, 965–985 (2020). https://doi.org/10.1007/s40279-019-01251-1

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