Thesis (doctor of medicine)--Universitetet i Lund.

Thesis (doctor of medicine)--Universitetet i Lund.

Bakgrund: Ljumskskador, ljumsk- och höftsmärta hos fotbollsspelare har oftast samband med minskat rörelseomfång i höfter, svaghet i bål och höftmuskulatur. Risk för ljumsksmärta ökar hos idrottare som inte tränar skadepreventivt. Syfte: Att undersöka om ett preventionsprogram med sex övningar för styrka och rörlighet kan minska förekomsten av ljumsksmärta hos herrfotbollsspelare. Material och metod: En kvantitativ experimentell fallstudie med kontrollgrupp, som utfördes med 14 herrfotbollslag (7 lag interventionsgrupp, 7 lag kontrollgrupp). I studien deltog 514 manliga fotbollspelare i åldern mellan 15-47 år. Resultat: I interventionsgruppen som genomförde ett preventionsprogram var antalet spelare med ljumsksmärta oförändrat, medan antalet deltagare med ljumsksmärta i kontrollgruppen ökade. Konklusion: Ett preventionsprogram med övningar för styrka och rörlighet kan förebygga förekomst av ljumsksmärta hos herrfotbollsspelare. Nyckelord: Fotboll, prevention, ljumskskada, ljumsksmärta, höftsmärta / Background:Groin injuries, groin pain and hip pain for soccer players are often associated with decreased range of motion (ROM) in the hip, weakness in abdominal muscles and poor hip muscles. The risk of groinpain increases for athletes who do not practice any preventing exercises. Objective:To research if an injury prevention program with six exercises for strength and mobility has any effect on groin pain and hip pain for male soccer players. Measures and Methods: Quantitative experimental study with control group. 14 male soccer teams participated (7 teams in intervention group, 7 teams in control group). In the study 514 male soccer players participated, in the age of 15-47 years. Result: In the intervention group who practiced the prevention program did not the number of players with groinpain increased, compared with the control group where the numbers of players with grioinpain increased. Conclusion: An injury prevention program for male soccer players with exercises for strength and mobility could prevent increase of groinpain among male soccer players. Keywords: Soccer, prevention, groin injury, groin pain, hip pain

Background: This study aimed to evaluate physical function, measured with self-reported outcomes and performance-based measures (PBMs), in patients 6-10 months following hip arthroscopy (HA) compared to an asymptomatic control group.   Methods: A cross-sectional comparison (21 patients, 22 controls) based on self-reported outcomes (HAGOS), range of motion (ROM), muscle strength and PBMs (The Y-balance test (cm), medial and lateral triple hop test (cm) and Illinois agility test (s)). Independent sample t test was performed to asses between-group differences.   Results: HA-patients reported significantly worse self-reported outcomes in all HAGOS subscales, greatest difference was in QoL (-37,3 (95% CI -47,9; -26,8) p<0.001). HA-patients also reported significantly lower results (p<0.05) in active and passive flexion (ROM) and external rotation (strength). No significant differences were observed regarding PBMs.   Conclusions: HA-patients reported significantly lower hip function following HA compared with the control group. Lower muscle strength and ROM were observed in patients however, few differences were significant. No significant differences were observed regarding PBMs. This could indicate that physical function is re-established in patients 6-10months after surgery or that tests were not sensitive enough to detect potential remaining functional limitations in this patient group.

Background: Hip and groin pain is common in ice hockey and particular in goaltenders, because their movement patterns make them particularly vulnerable. "Skate to the post-technique” (SMS-technique) is a relatively new technique that the goaltenders uses and no studies have been published where the SMS-technique is studied and the hypothesis is that the hip is subjected to high stresses which can lead to hip and/or groin pain. Purpose: The purpose of this study was to investigate the prevalence of hip/groin pain in male ice hockey goaltenders of elite level in Sweden and if factors such as age, level of SMS-technique use and prevention training can be linked with the pain. The study also examines whether the goalies are concerned of injuring the hip and/or groin. Method: Descriptive and comparative cross-sectional study consisted of an online survey in which 57 % of 94 goaltenders participated. Results: A total of 63 % responded that they have pain in the hip/groin every month or more frequently. Over half of the goaltenders follow a specific training program and a significant difference in pain incidence was seen between them and those who do not follow a training program, p = 0.01. Most responded that they are more or less worried of getting hurt in the hip/groin. No significant difference in the occurrence of pain could be observed at different degrees of using SMS-technique. Conclusion: Many goaltenders have hip/groin pain and those who have pain are more often following a specific exercise program to prevent injuries in the hip and/or groin. / Bakgrund: Höft och ljumsksmärta är vanligt inom ishockey och främst hos målvakterna eftersom deras rörelsemönster gör dem extra utsatta. ”Skridsko mot stolpe-tekniken” (SMS-tekniken) är en relativt ny teknik som målvakter använder och inga studier har i nuläget publicerats där den studerats och hypotesen är att höften utsätts för stora påfrestningar vilket kan leda till höft/ljumsksmärta. Syfte: Syftet med studien var att undersöka prevalensen av höft/ljumsksmärta hos manliga ishockeymålvakter på elitnivå i Sverige samt om faktorer som grad av SMS-teknikanvändande och förebyggande träning kunde kopplas samman med den smärtan samt om målvakterna var oroliga för att skada sig. Metod: Deskriptiv och komparativ tvärsnittsstudie som bestod av en webbaserad enkät som distribuerades till 94 målvakter och där 57 % deltog. Resultat: Totalt 63 % hade ont i höft/ljumske varje månad eller oftare. Över hälften av målvakterna följde ett specifikt träningsprogram och en signifikant skillnad i smärtprevalens kunde ses mellan dem och de som inte följde ett träningsprogram, p=0,01. De flesta var mer eller mindre oroliga för att skada sig i höft/ljumske. Ingen signifikant skillnad i smärtförekomst kunde ses vid olika grader av SMS-teknikanvändande. Konklusion: Många målvakter hade höft/ljumsksmärta och de som hade ont följde i högre grad ett specifikt träningsprogram för att förebygga skador.

Submitted as the dissertation component in partial fulfilment of the requirements for the degree of a Masters in Technology in Chiropractic in the department of Chiropractic and Somatology, Durban University of Technology, Durban, South Africa, 2017. / Background: Hip pain is a common problem. Motion palpation is a manual technique applied by the hands in various degrees of joint motion that specifically evaluates range of motion in relation to specific anatomical landmarks, joint play and end feel. Motion palpation remains one of the most used diagnostic techniques and yet it remains unclear whether or not it is a reliable, sensitive and specific tool; especially in the hip joint. Objectives: This study assessed intra- and inter-examiner reliability and clinical responsiveness of motion palpation when it is used as a diagnostic tool in patients with non-specific unilateral anterior hip pain and unilateral asymptomatic hip joints. Methods: Ten participants, between the ages of 18 and 60, were included in this study (three ballet dancers, three golfers and four participants from the general population). The participants were assessed randomly by three blinded examiners. All of the participants then received one adjustment delivered by the researcher (half on the symptomatic side and half on the asymptomatic). The participants were then re-assessed. Data was recorded on a data collection sheet and analysed using SPSS version 23. Intra-examiner reliability and clinical responsiveness were analysed using McNemar’s test and the Chi-Square Test of Independence. Inter-examiner reliability was analysed using Fleiss’ Kappa. Results: Intra-examiner reliability showed to be markedly better on the left-hand side for all three examiners. Kappa scores for inter-examiner reliability varied from none to perfect. The average pairwise agreement scores ranged from 33.3% to 100% at the first assessment, and from 46.6% to 100% in the second assessment. A mean and standard deviation were calculated for the pairwise agreements which represented the sensitivity and specificity respectively. Both showed improvement between the first and second assessments which is positive for inter-examiner reliability. Clinical responsiveness was shown to be absent for examiners A and B but was present for examiner C on the left. Conclusion: This study found that, contrary to the expectations of many clinicians, motion palpation has limited to poor levels of intra-examiner reliability, inter-examiner reliability and clinical responsiveness. This is however limited by the small sample size and methodological limitations in this study. Therefore, the role of palpation as a diagnostic tool used in the diagnosis hip dysfunction may be limited. / M