Hip and pelvis kinematics during a stork test in sports participants with unilateral adductor related groin pain

Du Plessis, Franci (2016-03)

Thesis (MScPhysio)--Stellenbosch University, 2016.

Thesis

ENGLISH ABSTRACT: Introduction Groin pain is one of the three most prevalent injuries obtained in sports such as soccer; Australian Rule football; Rugby Leagues and Ice Hockey. Research on the hip and pelvis biomechanics in adductor related groin pain in sport is scarce. Objective The purpose of this study was to determine if there are any differences in the hip and pelvis kinematics during the ten seconds Stork Test in sports participants with unilateral groin pain compared to their healthy matched controls. Methodology A descriptive study was conducted. Eighteen active sports participants were recruited from soccer and rugby clubs situated around the Cape Peninsula, Western Cape, South Africa. The three-dimensional (3D) hip and pelvis kinematics of nine cases with unilateral groin pain and ten healthy controls were analysed. Hip and pelvis kinematics were analysed in the CAF-3D Vicon Laboratory at Stellenbosch University, using an eight camera Vicon system. A positive adductor squeeze test was used as a diagnostic test during participant screening to include cases with unilateral groin pain. Each participant performed six ten second Stork Tests, three on the right and three on the left. The main outcome measures were 3D hip and pelvis kinematic from foot lift to foot contact, foot contact was defined as a moment during the movement when the vertical force on the plate exceeded a threshold of 30 N. Each of the unilateral groin pain cases were compared to their healthy matched controls. Descriptive statistical techniques were used for all outcome measures; means and standard deviation (SD) was calculated, followed by a Student’s t-test to determine significant differences between the cases and controls. For all outcomes with p-values equal to or below 0.05, the effect size was calculated using the Cohen’s D. Results The findings of this study indicated a significant increase (p=0.03) in the anterior/posterior pelvic tilt total range of motion of the unilateral groin pain cases in the sagittal plane compared to their matched healthy controls. Significantly increased (p=0.05) internal/external rotation of the pelvis was noted in the transverse plane in unilateral groin pain cases compared to their healthy controls. Conclusion Differences were found in the total range of motion in the pelvis between sports participants with unilateral adductor related groin pain and their matched controls. This may imply that the groin pain participants have a decreased ability to activate the stabilisers of the pelvis, adductors, abdominals and gluteus medius, in order to stabilise the pelvis during the movement. A possible reason for the decreased muscle control in the affected group can be decreased muscle strength or muscle inhibition due to pain. The findings may also imply that evaluation and rehabilitation of pelvis stability should be included in individuals suffering from groin pain. Future research should focus on exploring these muscular components during the Stork test, perhaps making use of EMG.

AFRIKAANSE OPSOMMING: Inleiding Lies pyn is een van die drie mees algemeenste beserings wat obgedoen word in sportsoorte soos sokker, Australieaanse Reëls Voetbal, Rugby en Ys Hokkie. Navorsing aangaande die heup en pelvis biomeganika in adduktor verwante lies pyn is sport is skaars. Doelwit Die doet van hierdie studie was om te bepaal of daar verskille in heup en pelvis kinematika is tydens ‘n tien sekonde oeievaar toets is in unilateral lies pyn sport deelnemer vergelyk met hulle gesonde ooreenstemmende kontroles. Metode ‘n Beskrywende studie is uitgevoer. Agtien aktiwe sport deelnemers was gewerf van sokker en rugby klubs gelee in die Kaapse Skiereiland, Wes-Kaap, Suid Afrika. Die drie demensionele (3D) kinematika van die heup en pelvis van nege gevalle met unilateral lies pyn en nege gesonde kontroles is ontleed. Heup en pelvis kinematika is ontleed in die CAF- 3D Vicon Laboratorium by Stellenbosch Universiteit, met behulp van ‘n agt kamera Vicon sisteem. A positiewe adduktor druk toets was gebruik as diagnostiese toets om deelnemers met unilateral lies pyn te werf. Elke deelnemer moes ses oeievaars toetse doen, drie links en drie regs. Die hoof uitkoms meting was die 3D heup en pelvis kinematika van voet lig tot voet kontak, voet kontak is beskryf as die oomblik gedurende die bewegig wat die vertikale krag op die druk plaat 30 newton oorskry. Elk van die unilateral liespyn deelnemers is vergelyk met ‘n gesonde ooreenstemmende kontrole. Beskrywende statistiese tegnieke was gebruik vir berekeninge van alle uitkoms maatreels; gemiddeldes en standaardafwykings (SA), gevolg deur ‘n Studente t-toets om beduidende verskille tussen die gevalle en kontroles te bepaal. Vir al die uitkomste met p-waardes gelyk of onder 0.05, is die effekgrootte bereken deur die Cohen’s D Resultate Die bevindinge van die studie dui op ‘n beduidende toename (p=0.03) in die anterior/posterior pelviese kanteling totale omvang van beweging by die unilaterale lies pyn deelnemers in vergelyking met hul ooreenstemmende kontroles. ‘n Beduindende toename (p=0.05) in die totale omvang van pelviese interne en eksterne rotasie is ook gevind in die unilateral lies pyn deelnemers in vergelyking met hulle ooreenstemmende kontroles. Gevolgtrekking Verskille was gevind in die totale omvang van beweging by die pelvis van sport deelmers met unilaterale adduktor verwante lies pyn. Dit mag impliseer dat die lies pyn deelnemers ‘n verminderde vermoe het om die stabiliseerders, adduktors, abdominale en gluteus medius, van die pelvis te aktiveer tydens beweging. A moontlike rede vir die verminderde spier beheer in die geaffekteerde groep kan verminderde spierkrag of spier inhibisie as gevolg van pyn wees. Die bevindinge mag ook impliseer dat evaluering en rehabilitasie van die pelvis stabiliteit in ag geneem moet word in individue wat met lies pyn sukkel. Toekomstige navorsing ka nook focus op die spier aksie tydens die oeievaars toets, met gebruikmaak van EMG tegnologie.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/98613
This item appears in the following collections: