Sex-specific movement differences in young adults with and without hip pain

描述(由申请人提供)：髋臼唇裂是年轻人，特别是女性髋关节疼痛的一个日益公认的来源，并已与髋关节骨关节炎(OA)的过早发展有关。最近，髋臼撞击(FAI)被认为是导致唇部损伤和骨关节炎的原因之一。在FAI中，髋关节疼痛发生在髋臼或股骨结构异常的情况下，这会导致髋关节屈曲和内旋转时骨骼之间的早期接触。目前FAI的治疗方法包括切除或重新定位股骨或髋臼，或两者兼而有之。虽然结构确实会导致臀部疼痛，但越来越多的证据表明，运动模式也可能起到重要作用。这一系列研究的长期目标是改善髋关节疼痛的治疗，特别是年轻人的治疗，这将防止或减缓软骨损伤的进展，从而减少髋关节置换的需要。这个项目的目的是评估FAI患者与没有髋部疼痛的人的运动模式，并测试这些模式中性别和肢体的特定差异。识别可能导致髋部疼痛的运动模式的差异可以改善髋部疼痛患者的非侵入性治疗。为了测试这些差异，我们将使用在FAI患者和没有臀部疼痛的患者的运动中收集的运动学数据来评估运动模式，这些运动包括行走、下台阶、仰卧直腿抬起和俯卧式髋关节伸展。我们假设，与没有髋关节疼痛的受试者相比，患有FAI的受试者将表现出更接近其髋关节末端运动的运动模式。我们认为，这些运动模式会导致受试者的臀部疼痛。我们还假设，患有FAI的女性将表现出与患有FAI的男性不同的运动模式。我们预计这种运动模式上的性别差异是因为结构异常在女性和男性中的分布不平等，而且在其他下肢损伤中也注意到了性别效应(例如，前交叉韧带撕裂，膝股疼痛)。此外，由于受试者经常有单侧疼痛，尽管双侧结构异常，我们假设FAI受试者疼痛的髋关节的运动模式将不同于未受损的髋关节。从这项研究中获得的知识有可能通过确定特定性别的运动模式来指导FAI患者的治疗，这些模式可以成为廉价和非侵入性治疗干预的目标。它还可以用来开发以神经肌肉再培训为重点的预防项目。 公共卫生相关性：我们将研究患有髋臼撞击(FAI)和髋部疼痛的人以及没有髋部疼痛的人，以确定FAI患者的运动方式是否与没有髋部疼痛的人不同。我们希望证明，与没有髋部疼痛的人相比，患有FAI的人在运动模式上有根本的不同。从这项研究中获得的知识可能会导致改善对髋部疼痛患者的物理治疗干预。

DESCRIPTION (provided by applicant): Acetabular labral tears are an increasingly recognized source of hip pain in young adults, especially females, and have been linked to the premature development of hip osteoarthritis (OA). Recently, femoroacetabular impingement (FAI) has been implicated as a cause of labral injury and OA. In FAI, hip pain occurs in the presence of a structural abnormality of the acetabulum or femur which results in early contact between the bones during hip flexion and internal rotation. Current treatment for FAI includes surgical procedures to resect or reorient the femur or acetabulum or both. While structure does contribute to hip pain, increasing evidence suggests that movement patterns may also play an important role. The long-term goal of this line of research is to improve treatment for hip pain, especially in young adults, which will prevent or slow the progression of chondral damage and thereby reduce the need for hip arthroplasty. The purpose of this project is to assess the movement patterns of people with FAI compared to people without hip pain and to test for sex- and limb- specific differences in these patterns. Identification of differences in movement patterns which may contribute to hip pain can improve non-invasive treatment for people with hip pain. To test for these differences, we will assess movement patterns using kinematic data collected during movements including walking, stepping down, supine straight leg raise and prone hip extension on subjects with FAI and subjects without hip pain. We hypothesize that subjects with FAI will display movement patterns which are closer to their end-range hip motion than subjects without hip pain. We believe that these movement patterns contribute to a subject's hip pain. We also hypothesize that females with FAI will display different movement patterns than males with FAI. We anticipate this sex difference in movement patterns because there is an unequal distribution of the structural abnormalities among females and males, and because a sex effect has been noted in other lower extremity injuries (e.g. ACL tears, patellofemoral pain). Furthermore, as subjects often have unilateral pain despite bilateral structural abnormalities, we hypothesize that subjects with FAI will display different movement patterns of the painful hip than the unimpaired hip. The knowledge gained from this research has the potential to redirect treatment for people with FAI by identifying sex-specific movement patterns which could be targeted by inexpensive and non-invasive therapeutic interventions. It also could be used to develop prevention programs focused on neuromuscular retraining. PUBLIC HEALTH RELEVANCE: We will study people with femoroacetabular impingement (FAI) and hip pain and people without hip pain to determine if people with FAI move differently than people without hip pain. We hope to demonstrate that people with FAI have fundamental differences in movement patterns compared to those without hip pain. The knowledge gained from this study may lead to improved physical therapy interventions for people with hip pain.