Dissertations / Theses on the topic 'Hip joint - Thesis'

Fundação Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro<br>A avaliação da qualidade de vida tem sido cada vez mais utilizada pelos profissionais da área de saúde para mensurar o impacto de doenças na vida dos pacientes, bem como para avaliar os resultados dos tratamentos realizados. O crescente interesse por protocolos de pesquisa clínica em doenças não degenerativas do quadril tem encontrado muitos obstáculos na avaliação objetiva de seus resultados, principalmente nos estudos de observação de novas intervenções terapêuticas, como a artroscopia. O Nonarthritic Hip Score (NAHS) é um instrumento de avaliação clínica, desenvolvido originalmente em inglês, cujo objetivo é avaliar a função da articulação do quadril em pacientes jovens e fisicamente ativos. O objetivo desse estudo foi traduzir esse instrumento para a língua portuguesa, adaptá-lo para a cultura brasileira e validá-lo para que possa ser utilizado na avaliação de qualidade de vida de pacientes brasileiros com dor no quadril, sem doença degenerativa. A metodologia utilizada é a sugerida por Guillemin et al. (1993) e revisado por Beaton et al. (2000), que propuseram um conjunto de instruções padronizadas para adaptação cultural de instrumentos de qualidade de vida, incluindo cinco etapas: tradução, tradução de volta, revisão pelo comitê, pré-teste e teste, com reavaliação dos pesos dos escores, se relevante. A versão de consenso foi aplicada em 30 indivíduos. As questões sobre atividades esportivas e tarefas domésticas foram modificadas, para melhor adaptação à cultura brasileira. A versão brasileira do Nonarthritic Hip Score (NAHS-Brasil) foi respondida por 64 pacientes com dor no quadril, a fim de avaliar as propriedades de medida do instrumento: reprodutibilidade, consistência interna e validade. A reprodutibilidade foi 0,9, mostrando uma forte correlação; a consistência interna mostrou correlação entre 0,8 e 0,9, considerada boa e excelente; a validade foi considerada respectivamente boa e excelente; a correlação entre NAHS-Brasil e WOMAC foi 0,9; e a correlação entre o NAHS-Brasil e Questionário Algofuncional de Lequesne foi 0,79. O Nonarthritic Hip Score foi traduzido para a língua portuguesa e adaptado à cultura brasileira, de acordo com o conjunto de instruções padronizadas para adaptação cultural de instrumentos de qualidade de vida. Sua reprodutibilidade, consistência interna e validade foram também demonstradas.<br>The assessment of quality of life has been increasingly used by health professionals to measure the consequences of disease on patients' lives and evaluate the results of treatments. The growing interest in clinical research protocols of non-arthritic hip diseases has found many difficulties in dealing with the objective assessment of its results, especially in observational studies of new therapeutic interventions such as arthroscopy. The Nonarthritic Hip Score (NAHS) is a clinical assessment tool, originally developed in English to evaluate the function of the hip joint in young and physically active patients. The aim of this study was to translate this instrument into Portuguese, adapt it to the Brazilian culture and validate it, in order to evaluate quality of life of Brazilian patients with hip pain without osteoarthritis. The methodology used is suggested by Guillemin et al., (1993) and reviewed by Beaton et al., (2000), who proposed a set of standardized instructions for cultural adaptation of instruments for quality of life, including five steps: translation, back translation, review by committee, pre-test and test with a reassessment of the weights of scores, if relevant. The consensus version was administered to 30 individuals. Questions about sports and household chores were modified to better adapt to the Brazilian culture. The Brazilian version of Nonarthritic Hip Score (NAHS-Brasil) was answered by 64 patients with hip pain to evaluate the measurement properties of the instrument: reproducibility, internal consistency and validity. Reproducibility was 0.9, showing a strong correlation; the internal consistency showed a correlation between 0,8 and 0,9, considered good and excellent; the validity was considered good and excellent respectively; the correlation between NAHS-Brasil and WOMAC was 0,9, and the correlation between NAHS-Brasil and Lequesne Algofunctional Index was 0.79. The Nonarthritic Hip Score was translated into Portuguese and adapted to Brazilian culture, according to the instruction set of standardized instruments for cultural adaptation of quality of life. Its reliability, internal consistency and validity have also been demonstrated.

Articular cartilage degeneration, called osteoarthritis, in the hip joint is a serious condition that affects millions of individuals yearly, with limited clinical solutions available to prevent or slow progression of damage. Additionally, the effects of high-risk factors (e.g. obesity, soft and hard tissue injuries, abnormal joint alignment, amputations) on the progression of osteoarthritis are not fully understood. Therefore, the objective of this thesis is to generate a finite element model for predicting osteochondral tissue stress and strain in the human hip joint during gait, with a future goal of using this model in clinically relevant studies aimed at prevention, treatment, and rehabilitation of OC injuries. A subject specific finite element model (FEM) was developed from computerized tomography images, using rigid bones and linear elastic isotropic material properties for cartilage as a first step in model development. Peak contact pressures of 8.0 to 10.6 MPa and contact areas of 576 to 1010 mm2 were predicted by this FEM during the stance phase of gait. This model was validated with in vitro measurements and found to be in good agreement with experimentally measured contact pressures, and fair agreement with measured contact areas.

Current research suggests that femoroacetabular impingement can be a cause of osteoarthritis. Femoroacetabular impingement is a condition that can affect both the femur and the pelvis of an individual. Femoroacetabular impingement can cause damage to the hip joint and its surrounding tissues. The articular cartilage and the labrum are both affected by this condition. A cam impingement is where a bony protrusion develops at the femoral head/neck junction. A pincer impingement is where a bony protrusion develops at the acetabular rim. Often, patients are seen with a combination of both impingements. The main goal of this study was to computationally model and analyze acetabular stresses in a healthy hip, a hip with a cam impingement, a hip with a pincer impingement, and a hip with a combination of the two impingements. The bone models were taken from CT scans. The impingements were created by using Autodesk Maya to modify the surfaces of the models. The hip models were set up to model the single-leg stance phase of the walking cycle. For the most part, the impingements reduce the stress experienced by the femur. The only exception to this is that the cam femur paired with the pincer pelvis experienced the highest maximum principal stress in the proximomedial region. The pincer impingements increase both the maximum and minimum principal stresses experienced in the acetabulum. Overall, the two types of femoroacetabular impingement change the stress experienced by both the femur and the pelvis. The results of this study demonstrate that acetabular stresses can increase as a result of femoroacetabular impingements. These increased stresses can lead to damage in the hip joint which presents a clinical problem.

Thesis (MScPhysio)--University of Stellenbosch, 2011.<br>ENGLISH ABSTRACT: Aim: The aim of the study was to improve understanding of the hip joint kinematics in cricket fast bowlers and to ascertain whether a relationship exists between hip joint biomechanical parameters, including kinematics, ROM characteristics and lumbar symptoms. Study design: A descriptive cross-sectional study was conducted. Participants: Sixteen adult male fast bowlers between the ages of 18 and 40 years old, playing first-club league, were featured in the study. Main outcome measures: To obtain data with regards to the training history, as well as the nature of lumbar-spine symptoms experienced by the cricket fast bowlers, a newly designed questionnaire was compiled. For analysis of the front foot hip joint ROM and kinematics, the biomechanical equipment used included: a two-dimensional Canon MV950 Digital Video Camcorder, a Kodak EasyShare C310 camera and XSENS Motion Tracking equipment (Xsens Technologies B. V., Enschede, Netherlands). Results: Eight of the sixteen bowlers in our study experienced LBP in the season with seven of these bowlers presenting with recent symptoms most of which are experienced after bowling a spell and described as “tightness” or a “stabbing pain” in the lower back. Intensity of LBP ranged between 1/10 to 8/10. Front foot hip joint kinematics of fast bowlers showed highly individualised patterns of movement between different subjects. Medium amplitude movements in the flexion/extension as well as the rotation plane of movement showed a significant difference in bowlers with- and without LBP. No significant differences between groups with LBP and without LBP were found in the three passive hip ROM measurements. Conclusions: It has proved to be very difficult to improve the understanding of the front foot hip biomechanics in cricket fast bowlers due to the high inter-subject variability. Variability in movement patterns remains under-researched by sports biomechanics. Although decreased hip mobility could alter mechanical forces transmitted to the lumbar spine and therefore predispose or be a causative factor in LBP development, this study found no significant relation between these parameters. The sample size was very small in this study which will influence the validity of results. Our study confirmed the high incidence of LBP and preventative efforts for bowlers should therefore be strongly supported.<br>AFRIKAANSE OPSOMMING: Doelwit: Die doelwit van die studie was om die heupgewrig kinematika van krieket snelboulers beter te verstaan en om vas te stel of daar ‘n verwantskap bestaan tussen heupgewrig biomeganiese parameters, insluitende kinematika, omvang van beweging karakter en lumbale simptome. Studie ontwerp: ‘n Deursneë beskrywende studie is onderneem. Deelnemers: Sestien volwasse manlike snelboulers tussen die ouderdomme van 18 en 40 jaar oud wat eerste liga speel maak deel uit van die studie. Hoof uitkoms maatreëls: ‘n Nuut ontwerpte vraelys is opgestel om data aangaande oefen geskiedenis sowel as aard van lumbale simptome wat deur krieket snelboulers ervaar word in te samel. Die biomeganiese apparaat wat gebruik is vir die analiese van die voorvoet heup omvang van beweging, sowel as die kinematika, sluit in: ‘n twee dimensionele Canon MV950 Digitale Video Camcorder, ‘n Kodak EasyShare C310 kamera en XSENS beweging volgende apparaat (Xsens Technologies B. V., Enschede, Netherlands). Resultate: Agt van die sestien boulers in ons studie het lae rug pyn in die seisoen ervaar. Sewe van die boulers het gepresenteer met onlangse simptome waarvan die meeste na ‘n bouler se boulbeurt ervaar is en beskryf was as ‘n “styfheid” of “steekpyn” in die lae rug. Die intensiteit van die lae rug pyn het gewissel tussen 1/10 en 8/10. Voorvoet heup kinematika van snelboulers het hoogs individualistiese patrone van beweging getoon tussen verskillende deelnemers. Medium amplitude bewegings in die fleksie/ekstensie sowel as die rotasie plein van beweging het ‘n beduidende verskil tussen boulers met- en sonder lae rug pyn getoon. Geen beduidende verskille tussen die groep met- en sonder rugpyn is gevind met die drie passiewe heup omvang van beweging meetings nie. Gevolgtrekkings: Dit blyk baie moelik te wees om die voorvoet heup biomeganika in krieket snelboulers beter te verstaan a.g.v. die hoë inter-deelnemer veranderlikheid. Veranderlikheid in bewegings patrone is nog nie genoeg nagevors deur sport biomeganici nie. Alhoewel ingekorte heup mobiliteit meganiese kragte wat deur die lumbale werwelkolom gaan kan wysig, en sodoende die ontwikkeling van lae rug pyn kan predisponeer of ‘n oorsakende faktor kan wees, het hierdie studie nie ‘n beduidende verwantskap tussen die parameters gevind nie. Die steekproef groote was baie klein en dit sal die geldigheid van die resultate beïnvloed. Ons studie het die hoë insidensie van lae rug pyn bevestig en pogings tot voorkomende maatreëls moet daarom ten sterkste ondersteun word.

Thesis (PhD (Physics))--Stellenbosch University, 2009.<br>ENGLISH ABSTRACT: This dissertation investigates certain key aspects of mathematical modeling of HIV and TB epidemics in South Africa with particular emphasis on data from a single well-studied community. Data collected over a period of 15 years (1994 to 2009) in Masiphumelele, a township near Cape Town, South Africa are used to develop a community-level mathematical model of the local HIV-TB epidemic. The population is divided into six compartments and a system of di®erential equations is derived to describe the spread of the dual epidemic. Our numerical results suggest that increased access to antiretroviral therapy (ART) could decrease not only the HIV prevalence, but also the TB noti¯cation rate. We present a modeling framework for studying the statistical properties of °uctuations in models of any population of a similar size. Viewing the epidemic as a jump process, the method entails an expansion of a master equation in a small parameter; in this case in inverse powers of the square root of the population size. We derive two-time correlation functions to study the correlation between di®erent types of active TB events, and show how a temporal element could be added to the de¯nition of TB clusters, which are currently de¯ned solely by DNA type. We add age structure to the HIV-TB model in order to investigate the demographical impact of HIV-TB epidemics. Our analysis suggests that, contrary to general belief, HIV-positive cases are not making a substantial contribution to the spread of TB in Masiphumelele. We develop an age-structured model of the HIV-TB epidemic at a national level in order to study the potential impact of a proposed universal test and treat program for HIV on dual HIV-TB epidemics. Our simulations show that generalized ART could signi¯cantly reduce the TB noti¯cation rate and the TB-related mortality rate in the short term. The timescale of the impact of ART on HIV prevalence is likely to be longer. We study the potential impact of more conventional control measures against HIV. Guidance for possible future and/or additional interventions emerge naturally from the results. We advocate a reduction in intergenerational sex, based on our ¯nding that 1.5-2.5 standard deviation in the age di®erence between sexual partners is necessary to create and sustain a major HIV epidemic. A simulation framework is developed to help quantify variance in age-structured epidemic models. The expansion technique is generalized to derive a Fokker-Planck equation. Directions for future work, particularly in terms of developing methods to model °uctuations and validate mixing assumptions in epidemiological models, are identi¯ed.<br>AFRIKAANSE OPSOMMING: Hierdie proefskrif ondersoek aspekte van die wiskundige modelering van HIV en TB epi- demies in Suid Afrika en fokus ook op 'n spesi¯eke gemeenskap. Data wat oor 'n periode van 15 jaar ingesamel is (1994 tot 2009) in Masiphumelele, 'n woonbuurt naby Kaapstad, Suid Afrika word gebruik om 'n wiskundige model te skep wat HIV-TB in die gemeen- skap modeleer. Die populasie word in ses kompartemente verdeel en 'n stel di®erensiaal vergelykings word afgelei om die verspreiding van di¶e epidemies te ondersoek. Ons nu- meriese resultate toon aan dat verhoogde toegang tot antiretrovirale behandeling (ARB) die potensiaal het om HIV prevalensie die TB koers beduidend te laat daal. Ons ontwikkel 'n raamwerk waarmee die statistiese eienskappe van °uktuasies ondersoek kan word in enige populasie van dieselfde grootte. Die metode ontwikkel 'n meester vergelyking vir die on- derliggende geboorte-dood stogastiese proses en brei dit uit in terme van 'n klein parameter; in di¶e geval in inverse magte van die vierkantswortel van die populasie grootte. Die twee-tyd korrelasie funksies word afgelei, en word gebruik om die korrelasie tussen verskillende tipes van TB episodes te bestudeer, asook om te wys hoe 'n tydselement aan die de¯nisie van TB groeperings gegee kan word. Di¶e word tans slegs d.m.v DNA tipe geklassi¯seer. Ouderdom- struktuur word aan die model toegevoeg om die demogra¯ese impak van HIV-TB epidemies te bestudeer. Ons analise toon aan dat, anders as wat algemeen aanvaar word, maak HIV- positiewe gevalle nie 'n groot bydrae tot die verspreiding van TB in Masiphumelele nie. Ons ontwikkel 'n ouderdom-gestruktureerde model van HIV-TB op nasionale vlak en gebruik die model om die potensiÄele impak van 'n universele toets- en behandel strategie op die HIV-TB epidemies te ondersoek. Ons simulasies toon aan dat algemene ARB waarskynlik 'n groot impak op die TB aanmeldings koers asook die TB-verwante mortaliteits koers kan h^e binne 'n relatiewe kort tydperk. Die impak op HIV prevalensie sal eers oor 'n veel langer periode duidelik word. Ons ondersoek ook die moontlikheid van meer konvensionele beheermaa- treels. Ons ontmoedig tussengenerasie seksuale omgang, gegrond op ons bevinding dat 'n standaard afwyking van 1.5-2.5 in die ouderdoms verskil tussen seksuele vennote, nodig is om 'n HIV epidemie van stapel te stuur en te onderhou. Ons ontwikkel 'n simulasie raamwerk om variansie in ouderdomgestruktureerde modelle te benader. Die uitbreidingstegniek word veralgemeen om 'n Fokker-Planck vergelyking af te lei. Ons identi¯seer probleme in die on- twikkeling van metodes om interaksie patrone en °uktuasies te modeleer in epidemiologiese modelle as opgawe vir toekomstige werk.

Thesis (MScPhysio)--Stellenbosch University, 2014.<br>ENGLISH ABSTRACT: Introduction-The golf swing is a complex, sequenced movement of body segments. This movement is smooth and well timed and is referred to as the kinematic golf sequence. This kinematic sequence illustrates the rotational speed, which occurs between the upper and lower body segments. Hip rotation plays an integral part to a sound kinematic sequence by providing a pivotal point between the upper and lower body segments, ensuring a synchronised golf swing. Hip rotation kinematics during a golf swing has received relatively little attention compared to other body segments’ movements. However, clinicians need to have a clear understanding of the rotational contribution that each hip make during golf swing in order to enhance the athlete’s performance and reduce the risk of injury. The aim of this descriptive research project was to obtain and investigate the total passive and total dynamic rotation range of movement in both the lead and trail hips of healthy, young adult, male golfers. Methodology-Seven, low handicapped, male golfers between the ages of 18 and 40 years were randomly selected in the Western Cape region from areas surrounding Stellenbosch University’s Tygerberg campus. A questionnaire gathered participant demographics that determined participatory eligibility. A preliminary reliability study established a baseline measurement for passive total articular hip rotation. Seatadjusted total passive hip rotation ranges of motion (ROM) measurements were collected with a hand-held inclinometer. Dynamic total hip rotation kinematic data was captured during a golf swing with an 8-camera video analysis system (VICON). Data analyses were performed with Statistica version 10. Hand-held inclinometer intra-rater reliability was determined with a two-way interclass correlation, standard error of measurement and a 95% confidence interval level. A Spearman correlation coefficient determined correlation between the total passive and total dynamic rotation range of movement in both the lead and trail hips. Results-Passive intra-rater reliability was reported as 0.81 (95% CI: 0.46-0.96). The total average passive articular range between the lead (62.1° ±6.4°) and trail hip (61.4° ±3.8°) did not report any significant difference (p=0.8). The total average dynamic golf swing articular range between the lead (29° ± 6.5°) and trail hip (35.° ±7.8°), was reported as significantly (p=0.04) asymmetric. The findings also demonstrated a positive correlation between the passive and dynamic total articular range in a lead hip, whereas a negative correlation was reported in a trail hip. During the golf swing the lead hip utilised 46.4%(± 8) of the total passive available hip rotation, whereas the trail hip utilised 58.8% (±13.2). Discussion and Conclusions-The findings of this study show that, the passive rotation ROM in a hip (LH=62°; TH=61°) of a golf player does not exceed the available range it has during a golf swing. The golfer’s hip utilises 46% of the available passive range of movement in the lead hip and 59% in the trail hip. In the clinical field careful consideration should be given to the motivation behind mobilizing, treating or stretching the hips of a golf player. These findings can be incorporated in future research on the relationship between hip-rotation ROM and reduction in the incidence of injuries amongst golfers.<br>AFRIKAANSE OPSOMMING: Inleiding-Die gholfswaai is n komplekse, opeenvolgende beweging van verskeie liggaamsegmente. Hierdie gladde opeenvolgende bewegings word die kinematiese gholfpatron genoem. Hierdie kinematiese opeenvolgende bewegings bied ’n illustrastrasie van die rotasiespoed waarteen die beweging tussen die boonste en onderste liggaamsegmente plaasvind. Heuprotasie speel ’n deurslaggewende rol in hierdie glad verlopende kinematiese proses. Dit dien as ’n spilpunt tussend die boonste en onderste kwadrant, wat op sy beurt weer ’n gesinkroniseerde gholfswaai verseker. Die heuprotasie kinamtieka tydens n gholfswaai het relatief minder aandag ontvang in vergelyking met ander liggaamsegmente. Klinici moet instaat gestel word om ’n duidelike begrip aangaande die bydrae wat heuprotasie tydens ’n golfswaai lewer, te ontwikkel. Die atleet se prestasie kan sodoende verbeter word, en die risiko tot beserings kan ook sodoende voorkom word. Die doel van hierdie beskrywende navorsingsprojek was om te bepaal wat die totale passiewe en die totale dinamies rotasie omvang van die leidende en volgende heupe van gesonde jong mans wat gholf speel, te ondersoek. Metodologie-Sewe gholf-geskoolde manlike gholf spelers met ’n lae voorgee en tussen die ouderdom van 18 en 40 jaar is ewekansig gekies. Hierdie kandidate is gekies uit die omliggende gebiede van die Stellenbosch Tygerberg kampus in die Wes-Kaap waar hulle relatief naby woonagtig was. ’n Vraelys is aangewend om demografiese eienskappe van elke deelnemer in te samel. Hierdie inligting wat deur die vraelys bekom is, is gebruik om te bepaal of die deelnemers in aanmerking is vir die studie. ’n Voorlopige, intra-meter betroubaarheidstudie is gedoen vir passiewe, totale artikulêre heuprotasiemetings wat met ’n hand hanteerbare hoek meter geneem is. ’n Algemene fisiese ondersoek is in die biomeganiese labaratorium afgehandel om te bepaal of die deelnemers geskik is vir die toetse. Sit-aangepaste passiewe totale hip rotasie beweging metings was ingesamel met 'n hand hanteerbare hoek meter. Intra-meter betroubaarheid is bepaal met ’n twee-rigting interklas korrelasie, standaard foutmeting en ’n 95% vertroue interval vlak. Dinamiese totale heup kinematiese rotasiedata is afgeneem met ’n hoë-spoed 3-D videografiestelsel (VICON) tydens 'n gholfswaai. Data-ontleding is bereken met ’n Statistica weergawe 10. Die gemiddelde en Spearman korrelasie koëffisiënt is gebruik as aanwysers van verspreiding. Resultate-Passiewe inter-meter betroubaarheid word geraporteer as 0.81 (95% KI: 0.46-0.96). Die resultate dui op ’n onbeduidende totale passiewe artikulêre reeks verskille tussen die leidende (voorste) (62.1 ± 6.4 °) en volgende (agterste) heupe (61.4 ° ± 3.8 °). ’n Beduidende totale dinamiese artikulêre reeks van die leidende (29 ° ± 6.5 °) en volgende heupe (35.9 ° ± 7.8 °) is tydens die gholfswaai bereik. Verdere resultate toon ’n positiewe korrelasie tussen die passiewe en dinamiese totale artikulêre reeks in die leidende heup, terwyl ’n negatiewe korrelasie gerapporteer word vir die volgende (agterste) heup. Tydens ’n gholfswaai gebruik die leidende heup 46.4% (± 8%) van die totale passiewe beskikbaar heuprotasie, terwyl die opvolgende (agterste) heup 58.8% (± 13.2%) aanwend. Bespreking en gevolgtrekking-Die bevindinge van hierdie studie toon dat tydens ’n gholfswaai, ’n gesonde gholfspeler nie die beskikbare passiewe beweging wat in sy heup bestaan oorskry nie. Slegs 46.4% van die beskikbare passiewe beweging in sy leidende heup word gebruik, en 58.8% van sy agterste heup. Die klinisie moet deeglike oorweging gegee word aan die motivering agter die mobilisering, strekke en die behandeling van die heupe van ’n gholfspeler. Hierdie bevindings kan in toekomstige navorsing geimplimenteer word om die verhouding wat tussen die omvange vand heuprotasie bestaan te ondersoek. Die voorkoming van moontlike toekomstige beserings in gholfspelers kan ook verhoed word.

Thesis (MScPhysio)--Stellenbosch University, 2014.<br>ENGLISH ABSTRACT: Introduction-Groin injuries are among the top six most cited injuries in soccer and account for 10-18 per cent of all injuries reported in contact sport. Groin pain can result from a variety of pathologies, but according to literature, 63 per cent of groin pain is due to adductor pathology. Objective-The objective of this study was to explore if there are kinematic differences in the hip joint in sports participants with groin pain compared to matched healthy controls. Study design A cross sectional, descriptive study was conducted. Study setting-The study was conducted at the FNB -3D motion analysis laboratory at the University of Stellenbosch, South Africa. Outcome variables-The dependent variables included hip kinematics in the sagittal, frontal and transverse planes at foot strike, lowest vertical point of the pelvis and total range of hip motion during a single leg drop landing. Methodology-The study sample comprised 20 male club level soccer-and, rugby players, running and cycling participants between the ages of 18-55 years of age. Ten of the subjects had chronic groin pain and the other ten were healthy matched controls. An eight-camera Vicon system was used to analyse the kinematics of the hip joint during single leg drop landing. For the purpose of comparison, the data was analysed for participants with unilateral groin pain and matched controls (n=14) and participants with bilateral groin pain and controls (n=6). The full set of data was subdivided for analysis into three distinct sub-groups. Unilaterally injured groin cases (n=7) were matched with seven healthy controls for analysis. Bilaterally injured groin cases (n=3) were matched with three healthy controls. Results-Cases with unilateral groin pain at initial contact had significantly more abduction of the hip joint when compared to controls (p<0.05). The effect size of this difference was large (0.94). Cases with unilateral groin pain also demonstrated greater hip internal rotation while the controls had external rotation (p<0.05) during a drop landing activity. Bilaterally injured groin cases landed with significantly (p=?) greater ranges of hip flexion as well as in significantly (p=?) more hip abduction during a drop landing activity. They also demonstrated greater total range of motion in the frontal plan when compared to controls. Groin pain cases overall demonstrated greater ranges of motion and tended to land in more abduction compared to controls. Conclusion-This study found that during a single leg drop landing, sports participants with unilateral chronic groin pain landed with significantly greater hip abduction and exhibited larger total range of motion in the transverse plane, which may indicate impaired stability of the hip complex when compared to controls.<br>AFRIKAANSE OPSOMMING: Inleiding-Liesbeserings is een van die top ses mees prominente sokker beserings. Dit beloop 10-18 persent van alle beserings wat in kontaksport aangemeld word. Liespyn kan die gevolg wees van ‘n verskeidenheid patologië, maar volgens die literatuur is 63 persent van liespyn as gevolg adduktor patologie. Doelwitte-Die doelwit van hierdie studie was om ondersoek in te stel of daar enige kinematiese veranderinge in die heupgewrig is in spelers met liespyn in vergelyking met dieselfde vergelykbare spelers sonder liespyn. Studie Ontwerp-‘n Deursnit, beskrywende studie was onderneem. Studie Omgewing-Die studie was uitgevoer by die FNB-3D bewegingsanalise laboratorium van die Stellenbosch Universiteit, Suid-Afrika. Uitkomsveranderlikes-Die afhanklike veranderlikes het in gesluit die heup kinematika in die sagitale, frontale en transvers vlakke met voet kontak endie laagste vertikale punt van die pelvis sowel as die totale heup omvang van beweging gedurende een been landing. Metodologie-Die studie populasie het bestaan uit 20 manlike sokker- en, rugbyspelers, hardlopers en fietsryers tussen die ouderdomme van 18 en 55 jaar. Tien van die deelnemers het kroniese liespyn gehad en die ander tien in die gelyke gesonde groep was sonder liespyn. Die agt kamera Vicon sisteem was gebruik om die kinematika van die heupgewrig te analseer tydens een been landing. Vir die doel om ‘n vergelyking te kan maak, was die data geanaliseer van deelnemers met unilaterale liespyn en die vergelykende groep sonder liespyn (n=14) en deelnemers met bilaterale liespyn en hulle vergelykende groep sonder liespyn (n=6).. Die volledige stel data was onderverdeel in drie afsonderlike sub groepe. Vir die analiese was unilaterale liesbeserings (n=7) vergelyk met sewe deelnemers sonder liespyn in die kontrolegroep. Deelnemers met bilaterale liesbeserings (n=3) was vergelyk met drie in die kontrolegroep. Resultate-Die deelnemers met unilaterale liespyn het met eerste kontak beduidend meer abduksie van die heupgewrig gehad in vergelyking met die kontrolegroep (p<0.05). Die effek van hierdie verskil was groot (0.94). Die deelnemers met unilaterale liespyn het ook ‘n grooter interne rotasie getoon, terwyl die kontrole groep meer eksterne rotasie gedemonstreer het (p<0.05) met landing. Deelnemers met bilaterale liespyn het beduidend (p=?) meer heup fleksie en abduksie omvang van beweging tydens landing. Hulle het ook ‘n groter totale heup omvang van beweging in die frontale vlak gehad in vergelyking met die kontrolegroep. Deelnemers met liespyn het oor die algemeen ‘n grooter omvang van beweging getoon, en was geneig om met meer abduksie van die heup te land as die kontrolegroep. Gevolgtrekking-Die studie toon dat deelnemers met kroniese unilaterale liespyn, tydens een been landing, beduidende meerheup abduksie toon en dat die heup in die transverse vlak meer totale omvang van beweging gebruik wat kan dui op onstabiliteit in die heupkompleks in vergelyking met die kontrolegroep.

Joint replacements are effective surgical interventions, yet some patients report experiencing ongoing physical and psychological symptoms post-operatively. An important parameter of recovery is exercise rehabilitation, yet little is known about the role of adherence in patient outcomes. Guided by the Common Sense Model and the Social Cognitive Theory the aim of this thesis was: (a) to identify determinants of exercise adherence, physical and emotional outcomes (b) and to examine whether adherence mediates the relationships between determinants and outcomes. In order to address these objectives a longitudinal study was first conducted. Osteoarthritis patients undergoing total hip and knee replacements (T1, n=54) were assessed at pre-surgery and at six weeks and nine months after surgery (T3, n=40). As determinants of adherence are multifactorial, factors that influence exercise adherence were further explored from a patients’ (n=8), and physiotherapists’ (n=5) perspective in a qualitative study using focus groups. A systematic review indicated that post-operative self-efficacy is a more consistent predictor of outcomes compared to pre-operative self-efficacy. Before surgery, emotional health was related to negative emotional reactions and strong beliefs of general self-efficacy while pre-operative physical status was associated with higher perceived illness identity and general self-efficacy. In a time-frame from baseline to nine months following surgery physical outcomes improved, exercise adherence decreased, emotional health remained stable while changes in patients’ cognitions and emotions were variable. Subsequently, changes in cognitions and emotions influenced post-operative outcomes. Early decrease in general self-efficacy and increase in consequences predicted early emotional outcomes while late changes in emotional representations and general self-efficacy predicted late emotional indicators. Early increase in chronic timeline perceptions and decrease in challenge emotion predicted early adherence while decrease in early personal control predicted lower late adherence. Increase in perceived consequences was the most consistent predictor of early functional outcomes whereas late increase in rehabilitation self-efficacy was the most consistent predictor of late physical outcomes. The mediation hypotheses were not confirmed. The qualitative study indicated a number of factors relating to the health care system-, health care professional- and patient level that may contribute to patients’ exercise adherence. The findings of the series of studies presented have implications in terms of the content and the implementation timing of future interventions aiming to optimize outcomes in this group of patients.