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

描述（由申请人提供）：越来越多的人认识到，髋臼盂唇撕裂是年轻人（尤其是女性）髋关节疼痛的一个来源，并且与髋关节骨关节炎（OA）的过早发生有关。最近，股骨髋臼撞击（FAI）被认为是盂唇损伤和OA的原因。在FAI中，髋关节疼痛发生在髋臼或股骨结构异常的情况下，这导致髋关节屈曲和内旋期间骨之间的早期接触。目前FAI的治疗包括切除或重新定向股骨或髋臼或两者的外科手术。虽然结构确实会导致髋关节疼痛，但越来越多的证据表明，运动模式也可能发挥重要作用。这项研究的长期目标是改善髋关节疼痛的治疗，特别是在年轻人中，这将预防或减缓软骨损伤的进展，从而减少髋关节置换术的需要。该项目的目的是评估与非髋关节疼痛的人相比，FAI的人的运动模式，并测试这些模式中的性别和肢体特异性差异。识别可能导致髋关节疼痛的运动模式差异可以改善髋关节疼痛患者的非侵入性治疗。为了检验这些差异，我们将使用在FAI受试者和无髋关节疼痛受试者的运动期间收集的运动学数据评估运动模式，包括行走、下台阶、仰卧直腿抬高和俯卧髋关节伸展。我们假设FAI受试者的运动模式比没有髋关节疼痛的受试者更接近髋关节运动的终点。我们认为这些运动模式有助于受试者的髋关节疼痛。我们还假设，女性FAI将显示不同的运动模式比男性FAI。我们预期这种运动模式的性别差异，因为女性和男性之间的结构异常分布不均匀，并且因为在其他下肢损伤（例如ACL撕裂，髌股疼痛）中已经注意到性别效应。此外，尽管双侧结构异常，但受试者通常单侧疼痛，因此我们假设FAI受试者的疼痛髋关节的运动模式与未受损髋关节不同。从这项研究中获得的知识有可能通过识别性别特异性运动模式来重新定向FAI患者的治疗，这些运动模式可以通过廉价和非侵入性的治疗干预来实现。它也可以用于开发专注于神经肌肉再训练的预防计划。

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.