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OCS - Current Concepts of Ortho PT > Hip > Flashcards

Hip Flashcards

1
Q

CAM deformity

A

Presence of excessive bone in the femoral head-neck region

An excessive (>60°) alpha angle

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2
Q

EMG studies have concluded that what exercise in weight bearing that produces significant gluteus medius muscle activity?

A

SL squat

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3
Q

Only direct muscular attachment to the sacrum

A

Piriformis

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4
Q

What 2 ligaments form the walls of the greater and lesser sciatic foramina

A

Sacrotuberous and sacrospinous ligaments

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5
Q

The amount of hip ROM is determined primarily by what?

A

Depth of the acetabulum and capsuloligamentous restraints

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6
Q

T/F: the entire femoral head is covered in hyaline cartilage?

A

False, all but the fovea (attachment of ligamentum teres)

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7
Q

Does the hip cartilage have vascular or neural supply?

A

It is limited with vascularity and aneural

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8
Q

Can pain in the hip be a result of cartilage involvement?

A

No, it’s aneural

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9
Q

Name of ligament connecting femur to acetabulum and location of attachment on femur

A

Ligamentum teres, fovea

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10
Q

Normal angle of inclination of the femoral neck/head

A

120°-125°

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11
Q

Coxa vara
- angle
- presentation

A

Angle of inclination <120°

Developmental or acquired

LLD, limping gait pattern, functional hip abd muscle weakness

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12
Q

Coxa valga
- angle
- presentation

A

Angle of inclination >135°

Compromised jt congruency = instability

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13
Q

Hip version (torsion) angle

A

Normal 8-20°

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14
Q

Anteversion of the hip
- high/low version angle
- in/out toeing
- Excessive ROM/limited ROM

A

High angle (>20°), In-toeing, excessive IR, limited ER

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15
Q

Retroversion of the hip
- high/low version angle
- in/out toeing
- Excessive ROM/limited ROM

A

Low version angle, out toeing, excessive ER, limited IR

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16
Q

What part of the proximal femur is most susceptible to fx?

A

Inferior area of the femoral neck (no trabuculae bone in that region)

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17
Q

Pincer FAI

A

Acetabulum has too much bone laterally (aka “over-coverage”)

Measured by LCEA (>40°)

Commonly associated with a retroverted acetabulum

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18
Q

Imaging of choice for diagnosis/assessment of acetabular angles (all)

A

CT

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19
Q

What region is cartilage the thickest in the acetabulum?

A

Superiorly (corresponding with weight bearing function)

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20
Q

What is located at the central acetabular fossa?

A

Fat pad, no cartilage

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21
Q

Are hip labral tears associated with degenerative changes

A

May be a precursor to cartilage damage due to not being able to distribute forces widely (happens in small area)

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22
Q

3 primary extra-articular ligaments

A

1) Iliofemoral
2) Pubofemoral
3) Ishiofemoral

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23
Q

What region of the hip is the capsule the thinnest

A

Posterior/inferior

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24
Q

Iliofemoral ligament limits what motion?

A

Extension, ER, add (superior band), abd (inf band)

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25
Q

Pubofemoral ligament limits what motion?

A

Abduction, secondary extension

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26
Q

Ishiofemoral ligament limits what motion?

A

IR, ext

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27
Q

Relevance of ligamentum teres in pediatrics

A

Thought to provide blood supply early on and decrease into adulthood

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28
Q

T/F: ligamentum teres plays a role in stability at the hip

A

Possibly, studies suggest it may help

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29
Q

Primary flexors of the hip

A

Iliopsoas and rectus femoris

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30
Q

Secondary flexors of the hip

A

Sartorius, TFL, pectineus, adductor longus

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31
Q

Young athlete, kicking sport, anterior hip pain should be screened for what?

A

Proximal rectus femoris apophyseal avulsion

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32
Q

Primary extensors of the hip

A

Gluteus max, HS

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33
Q

Secondary extensors of the hip

A

Glute Med, adductor magnus

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34
Q

T/F: the glute max also helps with hip abd and ER

A

True

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35
Q

Primary hip abductors

A

Glute med, glute min

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36
Q

Secondary hip abductors

A

TFL, glute max, piriformis, sartorius

All depends on position of the hip

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37
Q

Primary hip adductors

A

Adductor complex (add brevis, add longus, add magnus), pectineus, gracilis

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38
Q

T/F: there are no primary hip internal rotators

A

True, IR is not the primary function of any muscle in the hip region

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39
Q

3 clinically relevant bursae in the hip/pelvic region

A

1) Greater trochanter bursa
2) Iliopsoas bursa
3) Ischial bursa

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40
Q

Borders of the femoral triangle (anterior hip)

A

Upsidedown triagle shape:

Top = inguinal lig.
Lat = sartorius
Med = Add longus

Floor = iliopsoas and pectineus

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41
Q

What is the primary arterial supply for the leg

A

Femoral artery

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42
Q

Relevance of the femoral medial and lateral circumflex arteries

A

Branch off femoral artery, supply innervation to femoral head, if compromised causes AVN

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43
Q

Femoral nerve has what root levels

A

L2-L4

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44
Q

Vascular supply of the posterior hip

A

Branches of the internal iliac artery

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45
Q

Glute max and glute med/min/TFL are innervated by which gluteal nerves

A

Glute max = inferior gluteal

Glute med/min/TFL = superior gluteal

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46
Q

Loose packed position of the hip

A

30° flexion, 30° abduction, slight ER

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47
Q

Position for hip maximal articular congruency

A

90° hip flexion, slight abd and ER (quadruped)

However, position where jt dislocation is most common

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48
Q

Trendelenburg sign = drop ___ cm’s

A

> 2cm

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49
Q

Corticosteroid use can lead to what 2 conditions in the hip

A

AVN and fractures

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50
Q

Fluoroquinolone antibiotics can cause what condition at the hip

A

Gluteal tendinopathy

So if you have a pt with tendonitis and no MOI or other cause, screen for antibiotics

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51
Q

Slipped capital femoral epiphysis
- What is it
- Age range
- Sex
- Risk factor
- Unilat vs bilat

A

Growth plate is damaged and the femoral head moves (“slips”)

8-15 y/o, males, increased risk with obesity, bilat is common

If stable = non-surgical
If unstable = surgery

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52
Q

Legg-Calve-Perthes disease
- What is it
- Age range
- Sex

A

Disrupted blood supply to femoral head is temporarily interrupted = transient necrosis of the bone and deformities

4-10 y/o, boys

Self-limiting, non-surgical most of the time unless severe

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53
Q

Coxa saltans

A

aka Snapping hip syndrome

Iliopsoas over femoral head or proximal iliotibial tract over the greater trochanter

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54
Q

“C” sign typically indicates

A

Hip pain, impingement

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55
Q

Clinical prediction rule for inflammatory back pain - AS (can be hip as well)

A

1) Age <40 y/o @onset
2) Insidious onset
3) Better w/ exercise
4) No improvement w/ rest
5) Pain during 2nd half of night that improves w/ walking

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56
Q

How to differentiate between infection of the hip and gout

A

Typically will have big toe pain with gout

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57
Q

Reiter syndrome

A

aka Reactive arthritis

Type of arthritis that occurs due to an infection

Think: Can’t see, can’t pee, can’t climb a tree

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58
Q

Symptoms of hip fx

A

Extreme pain, extreme difficulty WB/flexing
and rotating hip/ambulating

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59
Q

AVN

A

30-50 y/o
Atraumatic
Very commonly had corticosteroid use
Pain >6wks
No ROM deficits early, but can mimic OA late
- D/T loss of blood supply

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60
Q

2 risk factors for stress fractures in endurance athletes

A

Female, previous stress fx

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61
Q

Female athlete triad

A

Low energy availability, menstrual dysfunction, low bone mineral density

Can put them at higher risk for stress fx’s

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62
Q

Compression-sided femoral neck stress fractures (FNSF)

A

Inferior-medial neck, LOW risk, non-surgical

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63
Q

Tension-sided femoral neck stress fractures (FNSF)

A

Superior-lateral neck, HIGH risk

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64
Q

Pubic rami stress fx

A

LOW risk, non-surgical, pain at inguinal/perineal regions

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65
Q

Symptoms of stress fx

A

Gradual onset, worse w/ activity and better w/ rest, pain at end-range PROM (specifically IR)

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66
Q

Patellar pubic percussion test

A

Stethoscope over pubic tubercle, tap on ipsilat patella

+ = lack of/diminished sound, pain

Good for femur fx’s, but unknown for stress fx’s

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67
Q

Gold standard for diagnosis of stress fx’s

A

MRI

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68
Q

Common Lumbopelvic screening tests

A

Prone instability test, thigh thrust, prone knee flexion test, lumbar ROM (single and repeated), neural tension tests, SIJ provocative tests

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69
Q

Are the SI joint cluster findings good at ruling in (specificity) or ruling out (sensitivity) SIJ pain?

A

Ruling OUT = 94% for 3/5 positive tests

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70
Q

To rule out pelvic involvement in hip pain what is the best outcome measure?

A

PGQ

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71
Q

Tests to assess lumbopelvic stability:
- Sagittal plane
- Frontal plane
- Rotational stability

A

Sagittal: Front plank
Frontal: Side-plank
Rotation: SL bridge

72
Q

MMT for glute med vs min

A

Sidelying for both

  • Glute min is in neutral (flex/ext/rotation)
  • Glute med is slight ext and ER
73
Q

Tests for anterior microinstability of hip joint

A

1) AB-HEER
2) HEER
3) Prone instability

+ test = pain in ant hip/groin

4) Log roll

+ test = increased ER of femur vs opposite

NOTE: cluster of 3 tests = 95% chance of instability

74
Q

What is the most accurate test overall for anterior microinstability of hip joint

A

AB-HEER test
(SN/SP in 80’s)

75
Q

Test for greater trochanteric pain syndrome

A

Gluteal de-rotation (high SN/SP)
SLS test (high SN/SP)

76
Q

Deep gluteal syndrome

A

Defined as pain in the buttock area caused from a non-discogenic entrapment of the sciatic nerve possibly by the piriformis muscle

77
Q

Tests for deep gluteal syndrome

A

Active piriformis test (Mod SN/SP)
Seated piriformis test (SP HIGH)

If used in combo with each other: SN 91% and SP 80%

78
Q

Ischiofemoral impingement (IFI)

A

Abnormal contact between lesser trochanter and ischium

79
Q

Tests for IFI

A

Long-stride (Better of the 2)
Sidelying ischiofemoral impingement test

80
Q

Tests to determine chronic proximal HS muscle involvement (cluster of 3)

A

1) Puranen-Orava test
2) Bent knee stretch test
3) Modified bent knee stretch test

NOTE: if traumatic onset, early testing that stresses the tissues inappropriately are CONTRAINDICATED

81
Q

Functional tests to assess valgus collapse of LE during dynamic task

Also have the 2 tests been validated?

A

Step-down, SL squat

Used to assess control of multiple jt’s during SL dynamic task

Yes, the tests have been validated in non-arthritic hip pain population (shown to have less pain and greater functional ability)

SL squat > step-down

82
Q

STAR Excursion Balance Test

A

Used to assess control of multiple jt’s during SL dynamic task

Assesses combo of strength, flexibility, balance, and proprioception

83
Q

Tests for functional performance in arthritic hip pain

A

6MWT, 30” chair stand, step test, TUG, self-paced walk, timed SLS, 4-square step test, stair measure

84
Q

MDC for 6MWT

A

48ft

85
Q

MDC for 30” chair stand test

A

3.5 reps

86
Q

MDC for step-test

A

3 steps

87
Q

MDC for SLS test

A

10.8 seconds

88
Q

Common cluster of findings in FAIS

A

Primary complaint is groin pain, “C” sign, functional limitations that involve end-range jt positions (especially in a repetitive manner), strength deficits (hip abd and ER/IR), tight hip flexor muscles (maybe)

89
Q

T/F: FABER and FADIR tests are both good for FAIS?

A

False, only FADIR has shown screening utility

90
Q

Is FAI a precursor to hip OA

A

Yes

91
Q

Applicable functional measures for FAIS and microinstability

A

Step-down, SL squat, SEBT test (better in FAI)

92
Q

Special test(s) for FAIS

A

FADIR

93
Q

Special test(s) for hip microinstability

A
  • Log-roll, FABER,
    AND 3 specific for anterior jt instability:
    AB-HEER, HEER, prone instability

may also have + Beighton scale

94
Q

Mechanical risk factors for hip OA

A

FAI, dysplasia, previous injury to the jt structures, high BMI

95
Q

What ROM loss is most prominent in hip OA

A

IR

96
Q

Special test(s) for hip OA

A

Scour, FABER, Long-axis distraction

NOTE: these tests are NOT included in OA cluster of findings

97
Q

Microinstability of the hip is most commonly caused by what?

A

Insufficient stabilization of the joint from the capsuloligamentous structures (anterior jt capsule and iliofemoral lig) that is caused by repetitive microtrauma

98
Q

Clinical presentation of hip microinstability

A

Groin/deep hip pain, “C” sign, functional difficulties w/ activities that combine loading the hip in ER/EXT, strength deficits (abd/rotators)

99
Q

Beighton scale
- what body parts
- what is threshold for laxity

A

Pinkies (>90° ext), thumbs (to forearm), knee and elbow hyperext (>10°), palms on floor

4/9 = threshold for presence of jt laxity

100
Q

What is the single leading factor related to hip OA before 50 y/o?

A

Hip dysplasia

101
Q

Hip dysplasia clinical findings

A

Hip ROM WNL or excessive, weakness (iliopsoas and hip abd), labral pathology, + FABER and FADIR (may be false +), + anterior hip instability tests

102
Q

Cluster for diagnosis of arthritis hip pain (OA)

A

1) Moderate ant or lat hip pain w/ weight bearing activities
2) Morning stiffness <1hr
3) Hip IR ROM <24°
OR
Hip IR and FLEX 15° less vs opposite side
4) Pain w/ PROM IR

103
Q

What balance tests are appropriate for hip OA?

A

BERG, 4 square step test, timed SLS test

104
Q

What functional outcome tests are appropriate for hip OA population?

A

6MWT, stair climbing, 30” chair stand test

105
Q

Coxa saltans external vs interna

A

Coxa saltans externa: laterally by the ITB
Coxa saltans interna: iliopsoas tendon

106
Q

Ilipsoas complex injuries are common in what sports?

A

Dance, football, soccer, ice hockey

Any running or kicking sport

107
Q

Adductor complex injuries are common in what sports?

A

Ice hockey and soccer

108
Q

What muscle is most commonly affected by adductor complex strain

A

Adductor longus

109
Q

Risk factors for hip adductor muscle injuries

A
  • Previous groin injury
  • Poor offseason training (ice hockey <18 sessions)
  • Hip muscle weakness
  • Decreased hip ROM
  • Lack of sport-specific training
110
Q

(Flexibility/strength) deficits have a stronger association with injury in hip muscle strains, specifically adductor complex injuries.

A

Strength

111
Q

Athletic Pubalgia

A

aka “Sports Hernia”

Abdominal and groin pain likely from weakening or tearing of the abdominal wall WITHOUT evidence of a true hernia

Commonly associated with adductor pain

112
Q

Cluster of signs/symptoms of Athletic Pubalgia

A

1) Deep groin pain
2) Pain increases w/ exertion, decreases w/ rest
3) TTP pubic rim 2-3cm lat to pubic tubercle
4) Pain w/ resisted hip add
5) Pain w/ resisted ab crunch

113
Q

Signs of immediate concern and referral to rule out HS tendon avulsion

A

Proximal posterior thigh pain w/ traumatic onset, inability/unwillingness to bear weight, visible ecchymosis, palpable deficits in proximal HS

114
Q

Cause of LE numbness/tingling post-HS injury

(NOT lumbar related)

A

Large hematomas can compress sciatic nerve

115
Q

More (distal/proximal) HS pain has been associated with longer recovery peroids

A

Proximal

116
Q

Is the width and length of the tender region in HS injuries important in prognosis?

A

Width = no
Length = predictive of return to sport

117
Q

Strongest predictor of a future HS injury?

A

Previous HS muscle injury

118
Q

Risk factors for HS injury

A
  • Previous HS injury
  • > age
  • Previous knee injury/surgery
  • Weakness
  • Decreased muscle length
  • Overall limb stiffness
  • Poor lumbopelvic stability
  • SIJ dysfunction
  • Proprioceptive deficits
119
Q

T/F: Recurrent HS injuries can lead to reduced sciatic nerve mobility

A

True, slump test has been recommended to assess

120
Q

Tightness in (quad/HS) has been shown to be associated with increased HS injury risk

A

Quadriceps

No association between HS tightness and injury!!

121
Q

T/F: Isolated HS strengthening and stretching is better vs agility and core stab program for reduction of HS re-injury rates

A

False, core stab and agility is BETTER vs isolated HS work

122
Q

Special tests for GTPS

A

FABER, gluteal de-rotation, SLS tests

NOTE: in athletic populations more dynamic SL activities may be indicated (step-downs, SEBT etc)

123
Q

Demographics of GTPS

A

Women, 40-65 y/o, can be in athletes

124
Q

Hallmark symptom of GTPS and common functional deficits

A

Lateral hip pain

Lying on side, stairs, walking, standing, sometimes sitting

125
Q

Recently, (more/less) emphasis has been placed on length of the ITB-TFL muscle fascial complex when assessing GTPS

A

LESS, more focus on strength (movement dysfunction)

126
Q

4 Clinical signs/symptoms for piriformis syndrome (w/ or w/o sciatica)

A

1) Buttock pain
2) Pain with sitting
3) TTP near greater sciatic notch
4) Pain w/ maneuvers that cause tension of piriformis

127
Q

What special tests are indicated for piriformis syndrome

A

Active piriformis test & seated piriformis test

When combined = Good screening and diagnostics

Can also use step-down task - as poor eccentric piriformis strength may contribute to excessive adduction and IR

128
Q

Special tests for IFI

A

Long-stride test & side-lying IFI

129
Q

NSAID use in hip OA

A

NSAID use is effective tx for symptoms (per CPG)

HOWEVER, some evidence associated it with increased fx risk in high activity population, may also increase progression of hip OA

130
Q

Interventions for FAIS

A

1) Early education and activity modification (avoid provoking positions)
2) Stretching (especially hip flexors)
3) Jt mobs
4) Strengthening (emphasize abd and rotator muscles)
5) Neuromuscular control/recruitment (i.e. perturbations)
6) Task-specific (step-downs, SL squats etc)
7) Lumbopelvic stab activities

131
Q

Is there return to play criteria for FAIS?

A

No, but recommended to use the one for knee injuries

132
Q

Interventions for hip microinstability

A

1) Education and activity mod (avoid repetitive end-range motions that stress passive stabilizers - ext and ER)
2) Neuromuscular re-ed (perturbations)
3) Strengthening (NWB in mid-range, progress to end-ranges as appropriate, ALSO hip abd/rotator/core are emphasized!)

Caution and possible avoidance of: stretching and mobs (especially those anteriorly)

133
Q

Interventions for hip dysplasia

A

1) Education & activity modification (Joint protection strategies, cross training or training volume modifications)
2) Exercises to address muscle weakness (progressive, not aggressive), postural control, and motor control deficits
3) Gait/running pattern training

Caution and possible avoidance of: stretching and mobs

134
Q

Interventions for hip OA

A

1) Education & activity modification (AD, jt protection strategies, BMI management)
2) Strengthening (especially glute med) w/ dosage (2-3x/wk 2-4 x 8-12 reps)
3) Manual therapy (Mobs, STM)
4) Flexibility/stretching (at least 60” total stretching time)
5) Endurance as appropriate
6) Functional/gait/balance training
7) Aquatic therapy if severe
8) Aerobic exercise (affects central pain mechanisms and mood)

135
Q

T/F: Combo heat and US with exercise is superior to just heat and exercise

A

True

NOTE: only demonstrated by one study

136
Q

Weight bearing restrictions for PNSF and pubic rami fx’s

A

Lasts 6-8 wks, prevent further progression of fx

137
Q

What type of exercises are appropriate for PNSF and pubic rami fx’s?

A

NWB exercises that address impairments, caution w/ supine and side-lying SLR activities, do emphasize glute med

Can also use aquatic therapy for “weight bearing” early on

138
Q

When can you progress exercises in PNSF and pubic rami fx’s? (from initial program)

A

When radiographic evidence shows fracture union

139
Q

Weight bearing restrictions S/P fixation of tension-sided fx’s

AND
Return to sport timeline

A

NWB 6wks, PWB 6wks

Return to sport ~3-6 months

140
Q

Are NSAIDS indicated for extra-articular injuries of the hip?

A

Use has been debated, there is a study that shows it can reduce strength loss, muscle soreness, and blood creatine kinase levels following ACUTE muscle injuries

141
Q

Interventions for iliopsoas complex injuries

A

1) Activity modification (avoid provoking activities, cross train to avoid deconditioning)
2) Stretching (can be used in combo w/ STM)
3) Gradual strengthening (LE/core)
4) Endurance exercises (this in combo w/ lumbopelvic strengthening should start early)
5) Return to sport/activity (when appropriate)

142
Q

Interventions for adductor injury

A

1) Education & activity mod (avoid excessive tension to adductors
2) Early on - gentle ROM hip/knee AND lumbopelvic stab
3) STM (evidence is lacking but favorable results have been noted)
4) Flexibility activities (ONLY once symptoms are stable)
5) Strengthening (isometric->concentric->eccentric)

143
Q

What is the criteria to progress out of the protective phase of rehab when it comes to adductor muscle strains?

A

Tolerance of therapeutic exercise, low-level ADLs, and symptom stability

144
Q

What is the adductor to abductor ratio?

A

In hockey players, you are 17x more likely to have an adductor strain if the muscle is less than 80% of their abductor strength

145
Q

What test should be used to evaluate return to sport in adductor strains?

A

Copenhagen 5” adductor squeeze test (0°, 30°, 45°, 90°)

NOTE: best @ 45° hip flexion

146
Q

During EARLY stage of HS strain rehab how long is max recommended time for immobilization

A

Max 3-4 days = to prevent excessive scar tissue formation

147
Q

During EARLY stage of HS strain rehab are mobilization and excessive stretching recommended?

A

NO, should be avoided

After short period of relative immobilization, ROM exercises in pain-free range is recommended

148
Q

T/F: Toe-touch or NWB gait patterns with crutches are recommended post-HS strain

A

FALSE, they may actually create excessive tensile loads on HS

INSTEAD, use flat foot and normal mechanics

149
Q

Interventions for EARLY phase of HS strain

A
  • 3-4 days immobilization
  • AVOID excessive stretching or early mobilization
  • After short period of rest = ROM exercises in pain-free range
  • Can use crutches if needed (only normal pattern or flat foot)
  • Therapeutic exercise = low intensity, within pain-free ranges (isometrics)
150
Q

Interventions for INTERMEDIATE phase of HS strain

A
  • LE and lumbopelvic strengthening (HS - progressive resistance, start w/ isotonics @mid-range)
  • Stretching (if no significant weakness)
  • Neural mobs prn
  • SL balance and proprioception
151
Q

Interventions for LATE phase of HS strain

A
  • Strength and flexibility progression (end-range, lengthened state, eccentric, high velocity)
  • Progress balance/proprioception
  • Sport specific or work training
152
Q

If significant HS weakness is noted in intermediate phase of rehab is aggressive end-range stretching encouraged?

A

NO, it should be avoided as musculotendinous unit is weakened and can’t prevent further injury during stretching

153
Q

What criteria is needed to switch from HS concentric strengthening to eccentric?

A

When good tolerance to all activities AND >50% HS strength vs opposite limb

154
Q

Return to sport criteria for HS injuries

A

None, can use H test (SLR 3x/quick w/ knee extended) can test apprehension

155
Q

Best sleeping position for those with severe GTPS

A

Supine w/ slight hip abduction

156
Q

Primary goal for tx of GTPS

A

Manage load and compressive forces at the greater trochanter region through strengthening (gluteals) and optimizing movement patterns

157
Q

Primary goal of tx for piriformis syndrome

A

Reduce muscle irritability and decrease compression of the sciatic nerve (if involved)

158
Q

Interventions for piriformis syndrome

A
  • Education/activity mod: minimize compression or lengthened state of the piriformis (avoid crossing legs, lying on one side w/ top leg crossed over, sitting on wallet)
  • STM: may be helpful as long as it doesn’t progress symptoms
  • Stretching (not aggressive)
  • Strengthening of hip/lumbopelvics
159
Q

Goal for tx of ischiofemoral impingement (IFI)

A

Minimzing the position of impingement of the quadratus femoris within the QFS

160
Q

What muscle group tightness may play a big role in IFI

A

Hip adductor tightness

161
Q

Interventions of IFI

A
  • Education and activity mod: MOI and pain management strategies
  • STM (limited evidence)
  • Dry needling (limited evidence)
  • Jt mobs (if capsular limitations)
  • Stretching (especially adductors, stretch them in extension)
  • Strengthening (especially abd and ER’s) of LE’s and lumbopelvic
162
Q

Evidence for jt mobilization in hip OA vs non-arthritic hip

A

Hip OA = STRONG
Hip non-arthritic = limited (use expert opinion)

163
Q

Evidence for dry needling in management of hip pain

A

Limited, may help for short-term pain relief (<12wks)

164
Q

Exercises that demonstrate relatively isolated glute medius muscle recruitment

A
  • Side-plank w/ hip abduction
  • Side-plank to neutral position
  • Front plank w/ hip ext
  • Side-lying hip abd
165
Q

Compound movements that show high glute medius recruitment:

A

SL squats, reverse lunges, variations of step-downs

166
Q

3 exercises with highest gluteal medius vs TFL recruitment ratio

A

1) Resisted clamshell
2) Resisted side-steps
3) SL bridge

167
Q

What exercise and its variations result in the greatest amount of glute max recruitment?

Other exercises show high potential for glute max muscle recruitment?

A

Step-ups

Other for glute max: hip thrust, squat, deadlift, lunges

168
Q

T/F: Lumbopelvic strengthening should be a standard consideration for ALL hip pathology

A

True

169
Q

Is use of bio-feedback for lumbopelvic stab activities indicated in hip population

A

Yes

170
Q

Are balance and gait training indicated in tx of hip pathology

A

Weak evidence for OA population, BUT it should be used to reflect goals and functional demands of the patient

171
Q

Outcome measures for non-arthritic hip conditions

A

1) Hip Outcome Score (HOS)
- ADL and sports

2) 33-item International Hip Outcome Tool (iHot-33)
- QOL in active patients

3) Copenhagen Hip and Groin Outcomes Scale (HAGOS)
- longstanding hip/groin pain

172
Q

Outcome measures for arthritic hip conditions

A

1) Western Ontario and McMaster Universities Arthritis Index (WOMAC)
- Instrument of choice for assessing consequences of hip or/and knee OA in elderly

2) Hip disability and Osteoarthritis Outcome Score (HOOS)
- QOL in pt’s w/ hip disability and OA

3) Modified Harris Hip Score (MHHS)
- Low level tasks

173
Q

LCEA angle

A

Lateral central edge angle (LCEA)
- Normal 25°-39°

174
Q

LCEA <25° = (overcoverage/undercoverage)

A

Undercoverage = dysplasia

175
Q

LCEA ≥40° = (overcoverage/undercoverage)

A

Overcoverage = pincer FAI

176
Q
A

OCS - Current Concepts of Ortho PT (12 decks)

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