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Effects of Examiner Strength on Reliability of Hip-Strength Testing Using a Handheld Dynamometer

David A. Krause, Mathew D. Neuger, Kimberly A. Lambert, Amanda E. Johnson, Heather A. DeVinny, and John H. Hollman


Hip-muscle impairments are associated with a variety of lower-extremity dysfunctions. Accurate assessment in the clinical setting can be challenging due to the strength of hip muscles relative to examiner strength.


To examine the influence of examiner strength and technique on manual hip-strength testing using a handheld dynamometer.


Repeated measures.


Research laboratory.


30 active adults (age 24 ± 1.4 y).


Three examiners of different strength performed manual muscle tests (MMT) in 2 different positions for hip extension, abduction, and external rotation using a MicroFet handheld dynamometer. Examiner strength was quantified via a 1-repetition-maximum leg press and chest press with a Keiser A420 pneumatic resistance machine.

Main Outcome Measures:

Intrarater reliability (ICC3,1), interrater reliability (ICC2,1), and measured torque values.


Intrarater reliability for all measurements ranged from .82 to .97. Interrater reliability ranged from .81 to .98. Main effects for hip extension revealed a significant difference in torque values between examiners and between techniques. For the short-lever hip-abduction and seated hip-external-rotation tests, there was a significant difference between examiners. There was no significant difference in measured torque values between examiners with the long-lever hip-abduction or the prone hip-external-rotation tests.


MMT of the hip may be performed with high reliability by examiners of different strength. To obtain valid MMT measurements of hip muscles, examiners must consider their own strength and testing techniques employed. The authors recommend a long-lever technique for hip abduction and a prone position for testing hip external rotation to minimize the influence of examiner strength. Both positions appear to provide mechanical advantages to the examiner compared with the alternative techniques. The authors are unable to recommend a preferred hip-extension-testing technique to minimize the influence of examiner strength.

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Golf after Total Hip Arthroplasty: A Retrospective Review of 46 Patients

Dennis Liem, Katharina Van Fabeck, Wolfgang Poetzl, Winfried Winkelmann, and Georg Gosheger


With the rising number of patients with total hip arthroplasty, there is demand for sporting activities for these patients to stay physically active.


The goal of this study was to evaluate satisfaction and golfing performance for golfers after total hip arthroplasty.

Study Design:

Retrospective cohort study.


Data of 46 golfers with an average age of 66.5 years (46–79 years) with an average follow up of 58.8 months (7–253 months) after total hip arthroplasty was analysed.


37 patients (80.4%) were able to return completely pain free, 9 patients still had pain during golf (19.6%). While satisfaction was high regardless of gender or affected side, only male golfers significantly improved their handicap and driving distance. Time spent on the golf course was the same pre- and postoperatively. Average time for returning to practice was 3.8 months; time until a full round of golf was 5.2 months. Postoperative physiotherapy was a significant factor in achieving an improved performance postoperatively.


Golfers can return to the golf course with the same frequency and performance level to stay physically active after total hip arthroplasty.

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Sedentary Behavior and Physical Activity Patterns in Older Adults After Hip Fracture: A Call to Action

Lena Fleig, Megan M. McAllister, Penny Brasher, Wendy L. Cook, Pierre Guy, Joseph H. Puyat, Karim M. Khan, Heather A. McKay, and Maureen C. Ashe


To characterize patterns of sedentary behavior and physical activity in older adults recovering from hip fracture and to determine characteristics associated with activity.


Community-dwelling, Canadian adults (65 years+) who sustained hip fracture wore an accelerometer at the waist for seven days and provided information on quality of life, falls self-efficacy, cognitive functioning, and mobility.


There were 53 older adults (mean age [SD] 79.5 [7.8] years) enrolled in the study; 49 had valid data and demonstrated high levels of sedentary time (median [p10, p90] 591.3 [482.2, 707.2] minutes/day), low levels of light activity (186.6 [72.6, 293.7]), and MVPA (2 [0.1, 27.6]), as well as few daily steps (2467.7 [617.1, 6820.4]). Regression analyses showed that age, gender, gait speed, and time since fracture were associated with outcomes.


Older adults have long periods of sedentary time with minimal activity. Results are a call to action to encourage people to sit less and move more.

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A Practical Estimation Method for Center of Mass Velocity in Swimming Direction During Front Crawl Swimming

Yuji Matsuda, Yoshihisa Sakurai, Keita Akashi, and Yasuyuki Kubo

practices. 6 , 7 Although these methods are considered conventional, the CoM velocity in swimming direction as estimated using the sacral marker method differs from the actual CoM velocity. 8 , 9 Fernandes et al 8 reported that the difference between the CoM and hip velocities in swimming direction is

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Rehabilitation Exercises for the Gluteus Minimus Muscle Segments: An Electromyography Study

Damien Moore, Adam I. Semciw, Jodie McClelland, Henry Wajswelner, and Tania Pizzari

The gluteus minimus (GMin) muscle is considered to be an important hip stabilizer 1 with its function derived from anatomical, 2 – 5 biomechanical, 6 , 7 radiological, 8 – 11 and electromyographic 12 , 13 studies. Its close relationship to the hip joint capsule and higher proportion of type 1

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Discriminatory Ability of Lower-Extremity Peak Torque and Rate of Torque Development in the Identification of Older Women With Slow Gait Speed

Mary Hellen Morcelli, Dain Patrick LaRoche, Luciano Fernandes Crozara, Nise Ribeiro Marques, Camilla Zamfolini Hallal, Mauro Gonçalves, and Marcelo Tavella Navega

gait speed. 7 , 8 Poor lower limb strength has been associated with slow gait speed and the likelihood of falling, making it an important predictor of functional status in older adults. 9 – 12 The association exists because joint torques at the hip, knee, and ankle are summed in a coordinated fashion

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Do Verbal and Tactile Cueing Selectively Alter Gluteus Maximus and Hamstring Recruitment During a Supine Bridging Exercise in Active Females? A Randomized Controlled Trial

John H. Hollman, Tyler A. Berling, Ellen O. Crum, Kelsie M. Miller, Brent T. Simmons, and James W. Youdas

Conditions contributing to hip pain are experienced across the lifespan. In young, active adults, anterior hip pain can be particularly problematic. Differential diagnoses for anterior hip pain in young adults range from extra-articular muscle injuries to intra-articular labral tears. 1 Hip pain

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Rehabilitation Exercises for the Gluteus Medius Muscle Segments: An Electromyography Study

Damien Moore, Tania Pizzari, Jodie McClelland, and Adam I. Semciw

(40 bpm), the side-lie hip abduction (50 bpm), the side-lie clam (40 bpm), the running man exercise (90 bpm), and the resisted hip abduction–extension exercise (60 bpm) with 2 minutes of rest between the trials and exercises. A series of maximum voluntary isometric contractions (MVICs) (across 6 hip

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Contact-Related Strain of Quadratus Femoris, Obturator Externus, and Inferior Gemellus in an Australian Football Player: A Case Report

Michael Girdwood, Liam West, David Connell, and Peter Brukner

season, with the most common injuries being in the lower limb. Of which, 50% of injuries were contact related. To date, however, there are no documented cases of acute injury to the deep hip rotators (quadratus femoris [QF], obturator externus [OE], obturator internus, and gemelli) in ARF. We present a

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Single-Leg Squat Test in the Clinical Setting Does Not Discriminate Patients With Femoroacetabular Impingement Syndrome From Asymptomatic Individuals

Letícia Almeida de Oliveira, Viviane Bortoluzzi Frasson, Anna Torresan, Marco Aurélio Vaz, and Bruno Manfredini Baroni

Femoroacetabular impingement syndrome (FAIS) is a hip movement-related disorder with a triad composed of symptoms, clinical signs, and imaging findings. 1 This disorder is characterized by anatomical changes in the contact between the acetabulum and the femoral head, which can be of the cam