Hip Adductor, Abductor Muscles Strength, and Performance in Participants with and without Low Back Pain
,
Abstract
Introduction: Weakness of hip muscles is common in individuals with chronic non-specific low back pain (CNSLBP). Also, hip joint performance can be influenced by the weakness of hip muscles. This study aimed to compare the strength and performance of hip adductor and abductor muscles between subjects with and without CNSLBP and to investigate their association with disability level.
Materials and Methods: This case-control study included 41 participants with CNSLBP and 41 healthy participants. The strength of hip abductor and adductor muscles were measured using a dynamometer and their performance was assessed using the one-leg hop test. The disability level in the CNSLBP group was assessed using the oswestry disability index (ODI). Data were analyzed using an independent sample t test and Pearson correlation coefficient.
Results: No significant differences were observed between groups for hip muscle strength. One-leg hop test scores of the left lower extremity in the lateral direction were significantly higher in the CNSLBP group compared to the control group. Also, no significant relationships were observed between the total score of ODI and hip muscle strength or performance in the CNSLBP group.
Conclusion: It’s recommended that evaluation and exercise therapy of participants with CNSLBP be performed during functional performance tasks.
1. Walker BF. The prevalence of low back pain: a systematic review of the literature from 1966 to 1998. Clinical Spine Surgery. 2000;13(3):205-17.
2. O’Sullivan PB, Grahamslaw KM, Kendell M, Lapenskie SC, Möller NE, Richards KV. The effect of different standing and sitting postures on trunk muscle activity in a pain-free population. Spine. 2002;27(11):1238-44.
3. Cooper NA, Scavo KM, Strickland KJ, Tipayamongkol N, Nicholson JD, Bewyer DC, et al. Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls. European Spine Journal. 2016;25(4):1258-65.
4. Arab AM, Nourbakhsh MR. The relationship between hip abductor muscle strength and iliotibial band tightness in individuals with low back pain. Chiropractic & osteopathy. 2010;18(1):1.
5. Nadler SF, Malanga GA, DePrince M, Stitik TP, Feinberg JH. The relationship between lower extremity injury, low back pain, and hip muscle strength in male and female collegiate athletes. Clinical Journal of Sport Medicine. 2000;10(2):89-97.
6. Hrysomallis C. Hip adductors' strength, flexibility, and injury risk. J Strength Cond Res. 2009;23(5):1514-7.
7. Nourbakhsh MR, Arab AM. Relationship Between Mechanical Factors and Incidence of Low Back Pain. The Journal of orthopaedic and sports physical therapy. 2002;32:447-60.
8. Kendall FP, McCreary EK, Provance PG, Rodgers M, Romani WA. Muscles, testing and function: with posture and pain: Williams & Wilkins Baltimore, MD; 1993.
9. Hides JA, Oostenbroek T, Franettovich Smith MM, Mendis MD. The effect of low back pain on trunk muscle size/function and hip strength in elite football (soccer) players. J Sports Sci. 2016;34(24):2303-11.
10. Niemuth PE, Johnson RJ, Myers MJ, Thieman TJ. Hip muscle weakness and overuse injuries in recreational runners. Clin J Sport Med. 2005;15(1):14-21.
11. Kivlan BR, Martin RL. Functional performance testing of the hip in athletes: a systematic review for reliability and validity. Int J Sports Phys Ther. 2012;7(4):402-12.
12. Patterson B, Culvenor AG, Barton CJ, Guermazi A, Stefanik J, Morris HG, et al. Poor functional performance 1 year after ACL reconstruction increases the risk of early osteoarthritis progression. British Journal of Sports Medicine. 2020;54(9):546.
13. Leister I, Kulnik ST, Kindermann H, Ortmaier R, Barthofer J, Vasvary I, et al. Functional performance testing and return to sport criteria in patients after anterior cruciate ligament injury 12–18 months after index surgery: A cross-sectional observational study. Physical Therapy in Sport. 2019;37:1-9.
14. Ahmed Hamada H, Hussein Draz A, Koura GM, Saab IM. Carryover effect of hip and knee exercises program on functional performance in individuals with patellofemoral pain syndrome. Journal of physical therapy science. 2017;29(8):1341-7.
15. Gombatto SP, Collins DR, Sahrmann SA, Engsberg JR, Van Dillen LR. Gender differences in pattern of hip and lumbopelvic rotation in people with low back pain. Clin Biomech (Bristol, Avon). 2006;21(3):263-71.
16. Roach SM, San Juan JG, Suprak DN, Lyda M, Bies AJ, Boydston CR. Passive hip range of motion is reduced in active subjects with chronic low back pain compared to controls. International journal of sports physical therapy. 2015;10(1):13-20.
17. Paatelma M, Karvonen E, Heiskanen J. Clinical Perspective: How Do Clinical Test Results Differentiate Chronic and Subacute Low Back Pain Patients from "Non-Patients"? Journal of Manual & Manipulative Therapy. 2009;17(1):11-9.
18. Reiman MP, Manske RC. The assessment of function: How is it measured? A clinical perspective. The Journal of manual & manipulative therapy. 2011;19(2):91-9.
19. Takala EP, Viikari-Juntura E. Do functional tests predict low back pain? Spine (Phila Pa 1976). 2000;25(16):2126-32.
20. Kovacs FM, Abraira V, Zamora J, del Real MTG, Llobera J, Fernández C. Correlation between pain, disability, and quality of life in patients with common low back pain. Spine. 2004;29(2):206-10.
21. Fisker A, Petersen T, Langberg H, Mortensen OS. The association between psychosocial distress, pain and disability in patients with persistent low back pain—A cross-sectional study. Cogent Medicine. 2018;5(1):1534536.
22. Lin C-WC, McAuley JH, Macedo L, Barnett DC, Smeets RJ, Verbunt JAJP. Relationship between physical activity and disability in low back pain: a systematic review and meta-analysis. 2011;152(3):607-13.
23. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344-9.
24. Kendall KD, Schmidt C, Ferber R. The relationship between hip-abductor strength and the magnitude of pelvic drop in patients with low back pain. Journal of Sport Rehabilitation. 2010;19(4):422-35.
25. ShahAli S, Arab AM, Ebrahimi E, ShahAli S, Rahmani N, Negahban H, et al. Ultrasound measurement of abdominal muscles during clinical isometric endurance tests in women with and without low back pain. Physiother Theory Pract. 2019;35(2):130-8.
26. Takeda K, Tanabe S, Koyama S, Nagai T, Sakurai H, Kanada Y, et al. Intra-and inter-rater reliability of the rate of force development of hip abductor muscles measured by hand-held dynamometer. Measurement in Physical Education and Exercise Science. 2018;22(1):19-24.
27. Wang C-Y, Olson SL, Protas EJ. Test-retest strength reliability: hand-held dynamometry in community-dwelling elderly fallers. Archives of physical medicine and rehabilitation. 2002;83(6):811-5.
28. Bazett-Jones DM, Cobb SC, Joshi MN, Cashin SE, Earl JE. Normalizing hip muscle strength: establishing body-size-independent measurements. Archives of physical medicine and rehabilitation. 2011;92(1):76-82.
29. Jaleh Farahmand F, Akbari M, Ebrahimi Takamjani E, Mohsenifar H. Effect of McKenzie Techniques on Muscle Strengthening in Anterior Knee Pain. Journal of Modern Rehabilitation. 2018;12(1)
30. Martín-San Agustín R, Benítez-Martínez JC, Castillo-Ballesta L, Gacto-Sánchez M, Medina-Mirapeix F. Validity, Reliability, and Sensitivity to Change of DiCI for the Strength Measurement of Knee and Hip Muscles. Measurement in Physical Education and Exercise Science. 2020;24(4):303-11.
31. Dingenen B, Truijen J, Bellemans J, Gokeler A. Test–retest reliability and discriminative ability of forward, medial and rotational single-leg hop tests. The Knee. 2019;26(5):978-87.
32. Kea J, Kramer J, Forwell L, Birmingham T. Hip abduction-adduction strength and one-leg hop tests: test-retest reliability and relationship to function in elite ice hockey players. Journal of Orthopaedic & Sports Physical Therapy. 2001;31(8):446-55.
33. Mani K, Brechue WF, Friesenbichler B, Maffiuletti NA. Validity and reliability of a novel instrumented one-legged hop test in patients with knee injuries. The Knee. 2017;24(2):237-42.
34. Mousavi SJ, Parnianpour M, Mehdian H, Montazeri A, Mobini B. The Oswestry Disability Index, the Roland-Morris Disability Questionnaire, and the Quebec Back Pain Disability Scale: translation and validation studies of the Iranian versions. Spine (Phila Pa 1976). 2006;31(14):E454-9.
35. Fairbank J, Couper J, Davies J, O’brien JJP. The Oswestry low back pain disability questionnaire. 1980;66(8):271-3.
36. Mousavi SJ, Parnianpour M, Mehdian H, Montazeri A, Mobini B. The Oswestry disability index, the Roland-Morris disability questionnaire, and the Quebec back pain disability scale: translation and validation studies of the Iranian versions. Spine. 2006;31(14):E454-E9.
37. Kyranoudis Á, Nikolaidis V, Ispirlidis I, Galazoulas C, Alipasali F, Famisis K. Acute effect of specific warm-up exercises on sprint performance after static and dynamic stretching in amateur soccer players. Journal of Physical Education and Sport. 2018;18(2):825-30.
38. Domholdt E. Rehabilitation research. Philadelphia, Pa.; London: Elsevier Saunders; 2005.
39. Bussey MD, Kennedy JE, Kennedy G. Gluteus medius coactivation response in field hockey players with and without low back pain. Phys Ther Sport. 2016;17:24-9.
40. Sutherlin MA, Hart JM. Hip-abduction torque and muscle activation in people with low back pain. J Sport Rehabil. 2015;24(1):51-61.
41. Marshall PWM, Patel H, Callaghan JP. Gluteus medius strength, endurance, and co-activation in the development of low back pain during prolonged standing. Human Movement Science. 2011;30(1):63-73.
42. Penney T, Ploughman M, Austin MW, Behm DG, Byrne JM. Determining the activation of gluteus medius and the validity of the single leg stance test in chronic, nonspecific low back pain. Arch Phys Med Rehabil. 2014;95(10):1969-76.
43. Moseley GL, Hodges PW. Are the changes in postural control associated with low back pain caused by pain interference? The Clinical journal of pain. 2005;21(4):323-9.
44. Michel J-P. Prevention of chronic diseases and age-related disability: Springer; 2018.
45. Sadler S, Cassidy S, Peterson B, Spink M, Chuter V. Gluteus medius muscle function in people with and without low back pain: a systematic review. BMC Musculoskeletal Disorders. 2019;20(1):463.
46. Al-Eisa E, Egan D, Wassersug R. Fluctuating asymmetry and low back pain. Evolution and Human Behavior. 2004;25(1):31-7.
47. Van Dillen LR, Bloom NJ, Gombatto SP, Susco TM. Hip rotation range of motion in people with and without low back pain who participate in rotation-related sports. Physical therapy in sport: official journal of the Association of Chartered Physiotherapists in Sports Medicine. 2008;9(2):72-81.
48. Okada T, Huxel KC, Nesser TW. Relationship between core stability, functional movement, and performance. The Journal of Strength & Conditioning Research. 2011;25(1):252-61.
49. Mills JD, Taunton JE, Mills WA. The effect of a 10-week training regimen on lumbo-pelvic stability and athletic performance in female athletes: a randomized-controlled trial. Physical Therapy in Sport. 2005;6(2):60-6.
2. O’Sullivan PB, Grahamslaw KM, Kendell M, Lapenskie SC, Möller NE, Richards KV. The effect of different standing and sitting postures on trunk muscle activity in a pain-free population. Spine. 2002;27(11):1238-44.
3. Cooper NA, Scavo KM, Strickland KJ, Tipayamongkol N, Nicholson JD, Bewyer DC, et al. Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls. European Spine Journal. 2016;25(4):1258-65.
4. Arab AM, Nourbakhsh MR. The relationship between hip abductor muscle strength and iliotibial band tightness in individuals with low back pain. Chiropractic & osteopathy. 2010;18(1):1.
5. Nadler SF, Malanga GA, DePrince M, Stitik TP, Feinberg JH. The relationship between lower extremity injury, low back pain, and hip muscle strength in male and female collegiate athletes. Clinical Journal of Sport Medicine. 2000;10(2):89-97.
6. Hrysomallis C. Hip adductors' strength, flexibility, and injury risk. J Strength Cond Res. 2009;23(5):1514-7.
7. Nourbakhsh MR, Arab AM. Relationship Between Mechanical Factors and Incidence of Low Back Pain. The Journal of orthopaedic and sports physical therapy. 2002;32:447-60.
8. Kendall FP, McCreary EK, Provance PG, Rodgers M, Romani WA. Muscles, testing and function: with posture and pain: Williams & Wilkins Baltimore, MD; 1993.
9. Hides JA, Oostenbroek T, Franettovich Smith MM, Mendis MD. The effect of low back pain on trunk muscle size/function and hip strength in elite football (soccer) players. J Sports Sci. 2016;34(24):2303-11.
10. Niemuth PE, Johnson RJ, Myers MJ, Thieman TJ. Hip muscle weakness and overuse injuries in recreational runners. Clin J Sport Med. 2005;15(1):14-21.
11. Kivlan BR, Martin RL. Functional performance testing of the hip in athletes: a systematic review for reliability and validity. Int J Sports Phys Ther. 2012;7(4):402-12.
12. Patterson B, Culvenor AG, Barton CJ, Guermazi A, Stefanik J, Morris HG, et al. Poor functional performance 1 year after ACL reconstruction increases the risk of early osteoarthritis progression. British Journal of Sports Medicine. 2020;54(9):546.
13. Leister I, Kulnik ST, Kindermann H, Ortmaier R, Barthofer J, Vasvary I, et al. Functional performance testing and return to sport criteria in patients after anterior cruciate ligament injury 12–18 months after index surgery: A cross-sectional observational study. Physical Therapy in Sport. 2019;37:1-9.
14. Ahmed Hamada H, Hussein Draz A, Koura GM, Saab IM. Carryover effect of hip and knee exercises program on functional performance in individuals with patellofemoral pain syndrome. Journal of physical therapy science. 2017;29(8):1341-7.
15. Gombatto SP, Collins DR, Sahrmann SA, Engsberg JR, Van Dillen LR. Gender differences in pattern of hip and lumbopelvic rotation in people with low back pain. Clin Biomech (Bristol, Avon). 2006;21(3):263-71.
16. Roach SM, San Juan JG, Suprak DN, Lyda M, Bies AJ, Boydston CR. Passive hip range of motion is reduced in active subjects with chronic low back pain compared to controls. International journal of sports physical therapy. 2015;10(1):13-20.
17. Paatelma M, Karvonen E, Heiskanen J. Clinical Perspective: How Do Clinical Test Results Differentiate Chronic and Subacute Low Back Pain Patients from "Non-Patients"? Journal of Manual & Manipulative Therapy. 2009;17(1):11-9.
18. Reiman MP, Manske RC. The assessment of function: How is it measured? A clinical perspective. The Journal of manual & manipulative therapy. 2011;19(2):91-9.
19. Takala EP, Viikari-Juntura E. Do functional tests predict low back pain? Spine (Phila Pa 1976). 2000;25(16):2126-32.
20. Kovacs FM, Abraira V, Zamora J, del Real MTG, Llobera J, Fernández C. Correlation between pain, disability, and quality of life in patients with common low back pain. Spine. 2004;29(2):206-10.
21. Fisker A, Petersen T, Langberg H, Mortensen OS. The association between psychosocial distress, pain and disability in patients with persistent low back pain—A cross-sectional study. Cogent Medicine. 2018;5(1):1534536.
22. Lin C-WC, McAuley JH, Macedo L, Barnett DC, Smeets RJ, Verbunt JAJP. Relationship between physical activity and disability in low back pain: a systematic review and meta-analysis. 2011;152(3):607-13.
23. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344-9.
24. Kendall KD, Schmidt C, Ferber R. The relationship between hip-abductor strength and the magnitude of pelvic drop in patients with low back pain. Journal of Sport Rehabilitation. 2010;19(4):422-35.
25. ShahAli S, Arab AM, Ebrahimi E, ShahAli S, Rahmani N, Negahban H, et al. Ultrasound measurement of abdominal muscles during clinical isometric endurance tests in women with and without low back pain. Physiother Theory Pract. 2019;35(2):130-8.
26. Takeda K, Tanabe S, Koyama S, Nagai T, Sakurai H, Kanada Y, et al. Intra-and inter-rater reliability of the rate of force development of hip abductor muscles measured by hand-held dynamometer. Measurement in Physical Education and Exercise Science. 2018;22(1):19-24.
27. Wang C-Y, Olson SL, Protas EJ. Test-retest strength reliability: hand-held dynamometry in community-dwelling elderly fallers. Archives of physical medicine and rehabilitation. 2002;83(6):811-5.
28. Bazett-Jones DM, Cobb SC, Joshi MN, Cashin SE, Earl JE. Normalizing hip muscle strength: establishing body-size-independent measurements. Archives of physical medicine and rehabilitation. 2011;92(1):76-82.
29. Jaleh Farahmand F, Akbari M, Ebrahimi Takamjani E, Mohsenifar H. Effect of McKenzie Techniques on Muscle Strengthening in Anterior Knee Pain. Journal of Modern Rehabilitation. 2018;12(1)
30. Martín-San Agustín R, Benítez-Martínez JC, Castillo-Ballesta L, Gacto-Sánchez M, Medina-Mirapeix F. Validity, Reliability, and Sensitivity to Change of DiCI for the Strength Measurement of Knee and Hip Muscles. Measurement in Physical Education and Exercise Science. 2020;24(4):303-11.
31. Dingenen B, Truijen J, Bellemans J, Gokeler A. Test–retest reliability and discriminative ability of forward, medial and rotational single-leg hop tests. The Knee. 2019;26(5):978-87.
32. Kea J, Kramer J, Forwell L, Birmingham T. Hip abduction-adduction strength and one-leg hop tests: test-retest reliability and relationship to function in elite ice hockey players. Journal of Orthopaedic & Sports Physical Therapy. 2001;31(8):446-55.
33. Mani K, Brechue WF, Friesenbichler B, Maffiuletti NA. Validity and reliability of a novel instrumented one-legged hop test in patients with knee injuries. The Knee. 2017;24(2):237-42.
34. Mousavi SJ, Parnianpour M, Mehdian H, Montazeri A, Mobini B. The Oswestry Disability Index, the Roland-Morris Disability Questionnaire, and the Quebec Back Pain Disability Scale: translation and validation studies of the Iranian versions. Spine (Phila Pa 1976). 2006;31(14):E454-9.
35. Fairbank J, Couper J, Davies J, O’brien JJP. The Oswestry low back pain disability questionnaire. 1980;66(8):271-3.
36. Mousavi SJ, Parnianpour M, Mehdian H, Montazeri A, Mobini B. The Oswestry disability index, the Roland-Morris disability questionnaire, and the Quebec back pain disability scale: translation and validation studies of the Iranian versions. Spine. 2006;31(14):E454-E9.
37. Kyranoudis Á, Nikolaidis V, Ispirlidis I, Galazoulas C, Alipasali F, Famisis K. Acute effect of specific warm-up exercises on sprint performance after static and dynamic stretching in amateur soccer players. Journal of Physical Education and Sport. 2018;18(2):825-30.
38. Domholdt E. Rehabilitation research. Philadelphia, Pa.; London: Elsevier Saunders; 2005.
39. Bussey MD, Kennedy JE, Kennedy G. Gluteus medius coactivation response in field hockey players with and without low back pain. Phys Ther Sport. 2016;17:24-9.
40. Sutherlin MA, Hart JM. Hip-abduction torque and muscle activation in people with low back pain. J Sport Rehabil. 2015;24(1):51-61.
41. Marshall PWM, Patel H, Callaghan JP. Gluteus medius strength, endurance, and co-activation in the development of low back pain during prolonged standing. Human Movement Science. 2011;30(1):63-73.
42. Penney T, Ploughman M, Austin MW, Behm DG, Byrne JM. Determining the activation of gluteus medius and the validity of the single leg stance test in chronic, nonspecific low back pain. Arch Phys Med Rehabil. 2014;95(10):1969-76.
43. Moseley GL, Hodges PW. Are the changes in postural control associated with low back pain caused by pain interference? The Clinical journal of pain. 2005;21(4):323-9.
44. Michel J-P. Prevention of chronic diseases and age-related disability: Springer; 2018.
45. Sadler S, Cassidy S, Peterson B, Spink M, Chuter V. Gluteus medius muscle function in people with and without low back pain: a systematic review. BMC Musculoskeletal Disorders. 2019;20(1):463.
46. Al-Eisa E, Egan D, Wassersug R. Fluctuating asymmetry and low back pain. Evolution and Human Behavior. 2004;25(1):31-7.
47. Van Dillen LR, Bloom NJ, Gombatto SP, Susco TM. Hip rotation range of motion in people with and without low back pain who participate in rotation-related sports. Physical therapy in sport: official journal of the Association of Chartered Physiotherapists in Sports Medicine. 2008;9(2):72-81.
48. Okada T, Huxel KC, Nesser TW. Relationship between core stability, functional movement, and performance. The Journal of Strength & Conditioning Research. 2011;25(1):252-61.
49. Mills JD, Taunton JE, Mills WA. The effect of a 10-week training regimen on lumbo-pelvic stability and athletic performance in female athletes: a randomized-controlled trial. Physical Therapy in Sport. 2005;6(2):60-6.
| Files | ||
| Issue | Vol 16 No 4 (2022) | |
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/jmr.v16i4.10758 | |
| Keywords | ||
| Low back pain Muscle strength Physical functional performance Disability evaluation Muscular weakness | ||
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How to Cite
1.
Jamalipour S, ShahAli S, Abdolhamidi J, Salehi S. Hip Adductor, Abductor Muscles Strength, and Performance in Participants with and without Low Back Pain. jmr. 2022;16(4):312-320.
