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An evidence-based review of hip-focused neuromuscular exercise interventions to address dynamic lower extremity valgus.

Ford KR, Nguyen AD, Dischiavi SL, Hegedus EJ, Zuk EF, Taylor JB - Open Access J Sports Med (2015)

Bottom Line: Deficits in proximal hip strength or neuromuscular control may lead to dynamic lower extremity valgus.Therefore, hip-focused interventions have gained considerable attention and been successful in addressing these knee pathologies.Previous electromyography, kinematics, and kinetics research support the use of targeted hip exercises with non-weight-bearing, controlled weight-bearing, functional exercise, and, to a lesser extent, dynamic exercises in reducing dynamic lower extremity valgus.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Therapy, High Point University, High Point, NC, USA.

ABSTRACT
Deficits in proximal hip strength or neuromuscular control may lead to dynamic lower extremity valgus. Measures of dynamic lower extremity valgus have been previously shown to relate to increased risk of several knee pathologies, specifically anterior cruciate ligament ruptures and patellofemoral pain. Therefore, hip-focused interventions have gained considerable attention and been successful in addressing these knee pathologies. The purpose of the review was to identify and discuss hip-focused exercise interventions that aim to address dynamic lower extremity valgus. Previous electromyography, kinematics, and kinetics research support the use of targeted hip exercises with non-weight-bearing, controlled weight-bearing, functional exercise, and, to a lesser extent, dynamic exercises in reducing dynamic lower extremity valgus. Further studies should be developed to identify and understand the mechanistic relationship between optimized biomechanics during sports and hip-focused neuromuscular exercise interventions.

No MeSH data available.


Related in: MedlinePlus

Late stage hip-focused exercises.Notes: (A) BOSU single knee balance. (B) Weighted runner. (C) Resisted band single leg squats. (D) Resisted vertical bridge. Note that the resisted band in (C) should apply a slight force that progresses the athlete to activate the hip musculature to prevent lower extremity valgus. Care should be taken to progress the exercises and magnitude of resistance.
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f5-oajsm-6-291: Late stage hip-focused exercises.Notes: (A) BOSU single knee balance. (B) Weighted runner. (C) Resisted band single leg squats. (D) Resisted vertical bridge. Note that the resisted band in (C) should apply a slight force that progresses the athlete to activate the hip musculature to prevent lower extremity valgus. Care should be taken to progress the exercises and magnitude of resistance.

Mentions: Attention should be devoted to developing evidence to support progression of exercises with varying bases of support (Figure 5A), sports-related tasks with external load (Figure 5B), and resisted bands (Figure 5C and D). For instance, the resisted vertical bridge (Figure 5D) is a potential progression from the supine bilateral bridge with the ability to add changes in resistance in a vertical posture. The upright position transitions from the bridge to a closed kinetic chain posture as the femur loads into the acetabulum, which could be considered a more functional position in relation to human movement. The vertical bridge also allows the opportunity to engage the free upper extremities into other more “functional activities” that can promote perturbations to the trunk, ultimately engaging more core musculature than the isolated nature of the supine bridge.


An evidence-based review of hip-focused neuromuscular exercise interventions to address dynamic lower extremity valgus.

Ford KR, Nguyen AD, Dischiavi SL, Hegedus EJ, Zuk EF, Taylor JB - Open Access J Sports Med (2015)

Late stage hip-focused exercises.Notes: (A) BOSU single knee balance. (B) Weighted runner. (C) Resisted band single leg squats. (D) Resisted vertical bridge. Note that the resisted band in (C) should apply a slight force that progresses the athlete to activate the hip musculature to prevent lower extremity valgus. Care should be taken to progress the exercises and magnitude of resistance.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556293&req=5

f5-oajsm-6-291: Late stage hip-focused exercises.Notes: (A) BOSU single knee balance. (B) Weighted runner. (C) Resisted band single leg squats. (D) Resisted vertical bridge. Note that the resisted band in (C) should apply a slight force that progresses the athlete to activate the hip musculature to prevent lower extremity valgus. Care should be taken to progress the exercises and magnitude of resistance.
Mentions: Attention should be devoted to developing evidence to support progression of exercises with varying bases of support (Figure 5A), sports-related tasks with external load (Figure 5B), and resisted bands (Figure 5C and D). For instance, the resisted vertical bridge (Figure 5D) is a potential progression from the supine bilateral bridge with the ability to add changes in resistance in a vertical posture. The upright position transitions from the bridge to a closed kinetic chain posture as the femur loads into the acetabulum, which could be considered a more functional position in relation to human movement. The vertical bridge also allows the opportunity to engage the free upper extremities into other more “functional activities” that can promote perturbations to the trunk, ultimately engaging more core musculature than the isolated nature of the supine bridge.

Bottom Line: Deficits in proximal hip strength or neuromuscular control may lead to dynamic lower extremity valgus.Therefore, hip-focused interventions have gained considerable attention and been successful in addressing these knee pathologies.Previous electromyography, kinematics, and kinetics research support the use of targeted hip exercises with non-weight-bearing, controlled weight-bearing, functional exercise, and, to a lesser extent, dynamic exercises in reducing dynamic lower extremity valgus.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Therapy, High Point University, High Point, NC, USA.

ABSTRACT
Deficits in proximal hip strength or neuromuscular control may lead to dynamic lower extremity valgus. Measures of dynamic lower extremity valgus have been previously shown to relate to increased risk of several knee pathologies, specifically anterior cruciate ligament ruptures and patellofemoral pain. Therefore, hip-focused interventions have gained considerable attention and been successful in addressing these knee pathologies. The purpose of the review was to identify and discuss hip-focused exercise interventions that aim to address dynamic lower extremity valgus. Previous electromyography, kinematics, and kinetics research support the use of targeted hip exercises with non-weight-bearing, controlled weight-bearing, functional exercise, and, to a lesser extent, dynamic exercises in reducing dynamic lower extremity valgus. Further studies should be developed to identify and understand the mechanistic relationship between optimized biomechanics during sports and hip-focused neuromuscular exercise interventions.

No MeSH data available.


Related in: MedlinePlus