Arthrogenic neuromusculature inhibition: a foundational investigation of existence in the hip joint.

Abstract

Patients and athletes with diminished gluteal muscle activation are thought to have 'gluteal inhibition'. This may be a component of arthrogenic neuromuscular inhibition, which has been well documented in the knee and generalized to all joints. While clinical evidence surrounding gluteal inhibition increases, supportive research is non-existent. This study investigated whether arthrogenic neuromuscular inhibition occurred about the hip following instillation of intra-articular fluid during functional hip extension tasks. Data was collected in a biomechanics laboratory (control) and hospital setting (intervention). Nine healthy individuals (4M/5F) comprised the control group. The intervention group contained twelve patients (4M/8F) with hip pathology requiring a magnetic resonance arthrogram (capsular distension via intra-articular fluid injection) procedure. The participants performed a pelvic bridge (PB) and active hip extension (EXT) before and after the control time or injection. Peak EMG from the gluteus maximus (GM) was collected bilaterally. The findings of this study provide substantial support for arthrogenic inhibition following hip intra-articular fluid instillation during functional tasks. Two-way repeated measures ANOVA revealed a significant group by session interaction effect (PB,EXT: affected/unaffected=0.0192/0.9654 P=0.05, <0.0001/0.0826 P=0.05). Tukey post hoc revealed decreases in ipsilateral peak GM EMG following intervention were significant (0.0238/<0.0001 P=0.025). No changes were observed in the control group. These concepts are of clinical importance to both patient and athletic populations. Understanding the role of gluteal inhibition in the injury process is essential to the development of rehabilitation and prevention protocols. Restoration and promotion of optimal recruitment patterns are crucial to enhancing athletic performance.