Search Results (134)

Multiple sclerosis (MS) is a chronic disease of the central nervous system that significantly impairs gait and mobility, contributing to a high risk of falls, reduced participation in daily activities, and diminished quality of life. Despite existing interventions such as exercise programs and pharmacological treatments, challenges such as fatigue, pain, and limited accessibility underscore the need for alternative therapies. Focal vibration therapy (FVT) has shown promise in improving gait, reducing spasticity, and enhancing mobility in people with MS (PwMS). However, further research is required to evaluate its long-term feasibility and optimize its parameters. This study examined the feasibility and preliminary efficacy of a home-based four-week wearable FVT device on gait and explored how FVT parameters impact gait and mobility outcomes. In this pilot double-blind randomized controlled trial, 22 PwMS were randomized into control and vibration groups (four FVT groups with varying vibration intensities/durations). Participants wore Myovolt^® vibrators on distal quadricep muscles near the rectus femoris insertion (approximately 2 cm from the medial edge of the patella), gastrocnemius/soleus, and tibialis anterior muscles (10 min/muscle, 3 days/week, 4 weeks). Feasibility was evaluated via adherence and satisfaction (QUEST 2.0, interviews). Gait (3D motion analysis) and mobility (T25FW) were assessed at baseline and post-intervention. Data were analyzed using descriptive/inferential statistics and thematic analysis. Of 22 participants, 17 completed post-intervention (16 intervention, 1 control). Wearable FVT showed promising feasibility, with high satisfaction despite minor adjustability issues. Intervention groups improved gait speed (p = 0.014), stride length (p = 0.004), and ankle angle (p = 0.043), but T25FW was unchanged (p > 0.05). High-intensity FVT enhanced knee/hip moments. This study’s results support the feasibility of wearable FVT for home-based management of mobility symptoms in MS with high participant satisfaction and acceptance. Notable gains in gait parameters suggest FVT’s potential to enhance neuromuscular control and proprioception but may be insufficient to lead to mobility improvements. Subgroup analyses highlighted the impact of vibration intensity and duration on knee joint mechanics, emphasizing the need for personalized dosing strategies. Challenges included participant retention in the control group and burdensome biomechanical assessments, which will be addressed in future studies through improved sham devices and a larger sample size. Full article

Background: Seiza, a traditional sitting posture requiring deep ankle plantarflexion and knee flexion, often becomes difficult after ankle fracture surgery because of restricted mobility. Increased stiffness of the tibialis anterior (TA) muscle, particularly in its deep and superficial fibres, may limit plantarflexion and affect functional recovery. This study aimed to investigate the relationship between TA muscle stiffness, assessed using shear wave elastography (SWE), and the ability to assume the seiza posture after ankle fracture surgery. We also sought to determine whether the stiffness in the deep or superficial TA fibres was more strongly correlated with seiza ability. Methods: In this cross-sectional study, 38 patients who underwent open reduction and internal fixation for ankle fractures were evaluated 3 months postoperatively. Seiza ability was assessed using the ankle plantarflexion angle and heel–buttock distance. The shear moduli of the superficial and deep TA fibres were measured using SWE. Ankle range of motion, muscle strength, and self-reported seiza pain were also measured. Multiple linear regression was used to identify the predictors of seiza performance. Results: The shear moduli of both deep (β = −0.454, p < 0.001) and superficial (β = −0.339, p = 0.017) TA fibres independently predicted ankle plantarflexion angle during seiza (adjusted R², 0.624). Pain during seiza was significantly associated with reduced plantarflexion, whereas muscle strength was not a significant predictor. Conclusions: TA muscle stiffness, especially in the deep fibres, was significantly associated with limited postoperative seiza performance. Targeted interventions that reduce deep TA stiffness may enhance functional outcomes. Full article

Quadricep weakness is frequently observed in patients following anterior cruciate ligament (ACL) injury or in those with knee osteoarthritis, often contributing to functional impairments and persistent symptoms. While high-intensity resistance training has been shown to effectively improve muscle strength, its application may be limited in certain populations due to pain or the risk of surgical complications. In recent years, blood flow restriction (BFR) training has emerged as a promising alternative. Growing evidence indicates that low-load BFR exercise can significantly improve muscle strength, induce hypertrophy, and enhance knee function, with outcomes comparable to those of high-intensity resistance training. When implemented using appropriate protocols, BFR training appears to be a safe and efficacious rehabilitation strategy for individuals with knee pathology. Full article

Background/Objectives: Patellar instability in adolescents is a significant cause of short- and long-term morbidity and disability. Traditionally, patients with first-time patellar dislocation are managed nonoperatively, although most studies are not focusing on the adolescent athletic population. The primary objective of the current study was to compare patient-reported outcomes and complications in adolescent athletes who underwent surgery either after the first patellar dislocation or after the recurrence of the dislocation with a minimum postoperative follow-up of 48 months (48–75 months). Methods: A total of 39 adolescent athletes who underwent medial patellofemoral ligament (MPFL) reconstruction (Group A, after the first dislocation, and Group B, recurrent patella dislocation) were included in this study. In all the patients, the same MPFL reconstruction technique was applied using a semitendinosus autograft. The graft was fixed on the patella using a transverse tunnel and adjustable loop button fixation and, in the femur, using a tunnel and absorbable screw fixation. The tunnel was drilled obliquely to prevent penetration of the distal femoral physis. The preoperative and postoperative clinical and functional evaluations of the patients were conducted via the visual analog scale (VAS), the Lysholm Knee Scoring System, the Kujala Anterior Knee Pain Scale, and the Pediatric International Knee Documentation Committee (Pedi-IKDC), and the return to sports score was assessed via the Tegner Activity Scale (TAS). Results: At the latest follow-up, both groups demonstrated significant improvement in the Lysholm scores, with Group A achieving a mean of 92.57 ± 6.21 and Group B achieving a mean of 90.53 ± 8.21 (p = 0.062). Postoperatively, Group A achieved a mean Kujala score of 94.21 ± 9.23, whereas Group B reached 92.76 ± 12.39, with no statistically significant difference (p = 0.08). The Pedi-IKDC score improved postoperatively in both groups. In Group A, it increased from 67.98 ± 12.29 to 93.65 ± 4.1, and in Group B, from 56.21 ± 13.6 to 91.67 ± 6.21 (p = 0.067). The preoperative visual analog scale (VAS) score for pain was significantly lower in Group A (3.1 ± 1.13) than in Group B (4.2 ± 3.01, p < 0.01). At the latest follow-up, the VAS scores improved in both groups, with Group A reporting a mean score of 0.47 ± 1.01 and Group B 0.97 ± 1.32 (p = 0.083). The Tegner activity scores were similar between the groups preoperatively, with Group A at 7.72 ± 1.65 and Group B at 7.45 ± 2.09 (p = 0.076). Postoperatively, Group A had a mean score of 7.28 ± 2.15, whereas Group B had a mean score of 6.79 ± 3.70 (p = 0.065). The mean time to return to sports was significantly shorter in Group A (5.1 ± 1.3 months) than in Group B (7.6 ± 2.1 months) (p < 0.01). Overall, 84.61% of the patients returned to their previous activity level. Specifically, 95.2% (20/21) of patients in Group A achieved this outcome, whereas 72.22% (13/18) achieved it in Group B. Patient satisfaction was generally high, with 76% (16/21) of patients in Group A reporting being satisfied or very satisfied, compared with 77% (14/18) in Group B. Conclusions: MPFL reconstruction is a safe and effective procedure for both acute and recurrent patellar dislocation in adolescent athletes. While patients who underwent acute reconstruction returned to sport more quickly and showed higher absolute postoperative scores, the greatest overall improvement from preoperative to final follow-up was observed in those treated for recurrent instability. Both surgical approaches demonstrated high satisfaction rates and minimal complications, supporting MPFL reconstruction as a reliable option in both acute and recurrent cases. Full article

The knee is one of the most frequently injured joints, involving various structures. To prevent reinjury after rehabilitation, braces are commonly used. However, most studies on knee supports focus on subjects with anterior cruciate ligament (ACL) injuries and do not account for muscle fatigue, which typically occurs during prolonged intense training and can significantly increase the risk of injury. Hence, this study investigates the acute effects of wearing a knee brace on biomechanics in subjects with a history of various unilateral knee injuries or pain under muscle fatigue. In total, 50 subjects completed an intense fatigue protocol and then performed counter-movement jumps and running tests on a force plate while tracking kinematics with a marker-based 3D motion analysis system. Additionally, subjects filled out a visual analog scale (VAS) to assess knee pain and stability. Tests were conducted on the injured leg with and without a knee brace (Sports Knee Support, Bauerfeind AG, Zeulenroda-Triebes, Germany) and on the healthy leg. Results indicated that wearing the knee brace stabilized knee movement in the frontal plane, with a significant reduction in maximal medio-lateral knee acceleration and knee abduction moment during running and jumping. The brace also normalized loading on the injured leg. We observed higher maximal knee flexion moments, which were associated with increased vertical ground reaction forces, segment velocities, and knee flexion angles. Subjects reported less pain and greater stability while wearing the knee brace. Therefore, we confirm that wearing a knee brace on the injured leg improves joint biomechanics by enhancing stability and kinematics and reducing pain during running and jumping, even with muscle fatigue. Consequently, wearing a knee brace after a knee joint injury may reduce the risk of reinjury. Full article

Diffuse type tenosynovial giant cell tumor (D-TGCT) of the knee presents with stiffness, pain and swelling with surgery being the mainstay treatment. However, the literature lacks data on clinical course of range of motion, pain (ROM), and swelling after open synovectomy for D-TGCT. Therefore, this study aims to evaluate clinical course after open anterior synovectomy. A retrospective analysis was conducted on 214 patients treated for TGCT at our Institutions between 2010 and 2023. 51 patients with anterior knee D-TGCT who underwent open anterior synovectomy were included. Pre- and postoperative assessments included ROM, pain (VAS scale), and reported swelling. The mean knee flexion increased from 100° (SD 14.28) preoperatively to 131.8° (12.64) at 12 months post-surgery. Knee extension remained stable, ranging from 178.4° preoperatively to 179.2° at the final follow-up. Pain decreased from a mean of 5.0 (SD 2.8) preoperatively to 0.5 (SD 0.7) at 12 months. Swelling was initially reported in 90.4% of patients, with 95.74% of them showing improvement at six months, and 100% at 12 months. Open anterior synovectomy effectively improves knee function, pain, swelling in patients with anterior knee D-TGCT, although functional recovery may take up to 6–12 months. Full article

Objectives: Tibial shaft fractures (TSFs) represent the most common diaphyseal fractures in adults. The gold-standard treatment is intramedullary nailing. Recently, the suprapatellar technique has been increasingly adopted due to its ability to reduce complications associated with the infrapatellar approach. Currently, no clinical score for leg fractures comprehensively assesses the entire lower limb. Therefore, we reviewed the main lower-limb scores available in the literature and developed a new clinical evaluation tool for tibial shaft fractures. The aim of our study was to report our experience with both techniques, to compare the outcomes of our prospective study with the international literature, and to propose a new, easy-to-apply, and reproducible clinical score that evaluates the specific functions of the entire lower limb. Methods: We conducted a prospective analysis of 920 tibial shaft fractures treated with intramedullary nailing via either a suprapatellar or infrapatellar approach. Patients were divided into two groups: Group A, including 420 patients treated with the infrapatellar approach; Group B, including 500 patients treated with the suprapatellar approach. Follow-up included clinical and radiographic assessments at 1, 3, and 6 months, and annually thereafter. We evaluated differences in patient positioning, operation time, radiation exposure, healing rate, incidence of pseudarthrosis and infection, return to ambulation, residual knee pain and fracture site, persistent lameness, and deformities. For the clinical assessment, we devised a new score—the Catania Hospital Score (CHS)—by integrating the most relevant clinical items from existing lower-limb evaluation tools. The CHS includes anterior knee pain (20 points), lameness (5 points), swelling (10 points), stair-climbing ability (10 points), tibial pain (15 points), the ability to perform daily activities (20 points), and evaluation of deformities (varus/valgus, shortening, rotation, and recurvatum/procurvatum (40 points)), for a total of 120 points. Results: Statistically significant differences were observed in Group B regarding a shorter surgical time, a reduced patient positioning time, and decreased radiation exposure. The CHSs were significantly better for Group B at the 3- and 6-month follow-ups. No statistically significant differences were found in infection or pseudarthrosis rates between the two groups. Notably, no cases of chronic knee pain were reported in patients treated with the suprapatellar approach. Conclusions: Both surgical approaches are valid and effective. However, our findings indicate that the suprapatellar approach reduces the complications of the infrapatellar technique, improves postoperative outcomes, and does not result in chronic knee pain. The CHS provides a comprehensive, practical, and reproducible tool to assess functional recovery in patients treated with intramedullary tibial nailing. Full article

Background: Patellar tendinopathy is a musculoskeletal pain condition capable of impairing physical or sport activities. Preliminary evidence supports the efficacy of percutaneous electrolysis (PE) in reducing pain and related disability in patients with patellar tendinopathy. Objective: This study proposes a theoretical model for the application of a percutaneous electrolysis approach targeting the deep zone of the proximal and distal parts of the patellar tendon in both human (ultrasound-guided) and fresh cadaver (not ultrasound-guided) models. Methods: A filiform solid needle was inserted from the lateral side of the patellar tendon targeting two areas: 1, the deep proximal interface of the Hoffa’s fat pad; and 2, the distal insertion of the patellar tendon at the tibial tuberosity in 10 fresh cadavers and in 10 healthy individuals. The patellar tendon, the saphenous nerve, and the infrapatellar nerve and its branches were identified by dissecting fresh cadavers to determine the anatomical trajectory of the infrapatellar nerve branches in relation to the needle. Results: The cadaveric model shows an anatomical relationship between the patellar tendon and infrapatellar nerve branches at the medial part of the knee. Infrapatellar nerve branches ran subcutaneously obliquely from the medial to the anterior and lateral parts of the knee, crossing in front of the patellar tendon. In all cadavers, the superior and inferior infrapatellar branches ran through the superior or inferior parts of the medial knee area. Only in 2/10 knees infrapatellar nerve branches reached the lateral part of the knee, specifically the superior lateral part. No neurovascular bundle of infrapatellar nerve branches was pierced in any insertion when the needle was inserted from the lateral part of the knee. Conclusion: This anatomical model supports the use of a lateral approach as a potentially safe approach to apply in needling interventions, e.g., percutaneous electrolysis for patellar tendinopathies. The infrapatellar nerve branches are vulnerable to needle procedures applied through the anteromedial side of the knee. Full article

Background and Objectives: Infrapatellar fat pad impingement syndrome (IFPIS) is a relatively underdiagnosed cause of anterior knee pain. While conservative management is the initial approach, some patients require surgical intervention. This study aimed to evaluate the long-term clinical and radiologic outcomes following arthroscopic resection of the infrapatellar fat pad in patients with IFPIS. Materials and Methods: Eighteen patients (10 females, 8 males; median age 22) diagnosed with IFPIS and unresponsive to conservative therapy underwent arthroscopic partial or subtotal resection between 2007 and 2013. Diagnosis was based on physical examination (Hoffa’s test), MRI findings, and response to lidocaine injection. Clinical outcomes (VAS, IKDC-2000, Kujala, Lysholm, Tegner activity scores) and radiologic assessments (ISR, CDI, PFJ osteoarthritis grade) were evaluated preoperatively, at 2 years, and at a final follow-up (mean 148.7 months). Results: All clinical scores significantly improved postoperatively. VAS decreased from 7.25 ± 0.79 to 2.43 ± 1.50 at 2 years, and to 3.66 ± 1.50 at the final follow-up (p < 0.001). Similar long-term improvements were observed in the Kujala, IKDC-2000, Lysholm, and Tegner scores (all p < 0.001). Radiographic parameters including ISR and CDI remained stable, and there was no statistically significant progression in patellofemoral osteoarthritis. However, 5 of 18 patients (27.8%) reported persistent symptoms at long-term follow-up. Conclusions: Arthroscopic resection of the infrapatellar fat pad in patients with IFPIS showed favorable and sustained clinical outcomes over a 10-year follow-up, without significant radiological changes. These results suggest that arthroscopic resection is a viable treatment option when accurate diagnosis is established. Full article

Background/Objectives: Patellofemoral pain (PFP) is considered a risk factor for knee osteoarthritis (OA) onset. The purpose of this study was to compare degenerative biomarkers in females with and without PFP and to determine changes in these levels, along with pain and function, over 6 months. Methods: All subjects received a knee x-ray to ensure that none had degenerative changes. Urine and serum were collected and analyzed for C-telopeptide fragments of type II collagen (CTX-II) and C-propeptide II (CP-II); these were then expressed as a cartilage degradation: cartilage synthesis ratio (CTX-II:CP-II). Subjects with PFP rated pain using a 10 cm visual analog scale, and function using the Knee injury and Osteoarthritis Outcome Scores-Patellofemoral (KOOS-PF) questionnaire. Subjects with PFP were tested at baseline and at 6 months. Results: Females with PFP had higher levels of CTX-II:CP-II than controls (p < 0.001) and these remained elevated at 6 months (p = 0.82). Females with PFP reported similar levels of pain (p = 0.30) but higher function at 6 months (p = 0.002). However, the 9.0-point increase in KOOS-PF values did not exceed the minimum important change. Conclusions: Females with PFP but no evident structural changes had more elevated biomarkers than controls. This finding suggests that this cohort may have excessive cartilage turnover which may contribute to knee OA. Full article

Lipedema is a painful disease of subcutaneous adipose tissue (SAT) in women. This study determined whether an advanced pneumatic compression device (APCD) improved lipedema SAT depth, swelling, and pain. Women with lipedema started 20–30 mm Hg compression leggings then were randomized to an APCD (Lympha Press Optimal Plus) group for 30 days (treatment; n = 22) or a no APCD (Control; n = 24) group. APCD treatment significantly reduced left leg volume (3D imaging, LymphaTech; p < 0.043) and fluid in the left (p = 0.0018) and right legs (p = 0.0476; SOZO, bioimpedance spectroscopy); controls showed no change. Treatment significantly decreased extracellular fluid (ECF) and intracellular fluid (ICF) in left (p = 0.0077; p = 0.0060) and right legs (p = 0.0476; p ≤ 0.025), respectively. Only ECF decreased significantly in the left (p < 0.0183) and right legs (p = 0.0009) in controls. SAT depth decreased significantly by ultrasound after treatment at the anterior (p ≤ 0.0234) and medial thigh (p ≤ 0.0052), medial knee (p ≤ 0.0002) and posterior calf (p ≤ 0.0118) but not in controls. All signs and symptoms of lipedema improved in the treatment group including swelling (p = 0.0005) and tenderness (pain) of right (p = 0.0003) and left legs (p < 0.0001); only swelling improved in controls (p = 0.0377). In total, 87.5% of RAND SF-36 quality of life improved after treatment (p ≤ 0.0351) compared to 37.5% in controls (p ≤ 0.0475). APCDs are effective treatment for lipedema. Full article

Focused ultrasound (FUS) is an emerging noninvasive technology with significant therapeutic potential across various clinical domains. FUS enables precise targeting of tissues using mechanisms like thermoablation, mechanical disruption, and neuromodulation, minimizing damage to surrounding areas. In movement disorders such as essential tremor and Parkinson’s disease, MR-guided FUS thalamotomy has demonstrated substantial tremor reduction and improved quality of life. Psychiatric applications include anterior capsulotomy for treatment-resistant obsessive-compulsive disorder and major depressive disorder, with promising symptom relief and minimal cognitive side effects. FUS also facilitates blood-brain barrier opening for drug delivery in neurological conditions like Alzheimer’s disease. Musculoskeletal applications highlight its efficacy in managing chronic pain from knee osteoarthritis and lumbar facet joint syndrome through precise thermal ablation. Additionally, FUS has shown potential in neuropathic pain management and peripheral nerve stimulation, offering innovative approaches for amputees and cancer survivors. Cognitive and neuromodulatory research underscores its ability to enhance motor function and interhemispheric cortical balance, benefiting stroke and traumatic brain injury rehabilitation. Despite these conditions frequently leading to various kinds of disabilities, no direct exploration of the possible FUS application in rehabilitation is yet available in the literature. All this considered, this review aims to discuss how FUS could be applied in rehabilitation, exploring the current status of knowledge and highlighting future directions. Full article

Background/Objectives: Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition that causes anterior knee pain, often linked to increased joint stress. Rehabilitation typically includes education, strength training, and functional exercises. Recently, telerehabilitation has become a promising alternative, particularly useful in improving access to care in rural areas. This study compares the effects of supervised (SE), web-based (WBE), and self-guided (SGE) exercise programs on pain, functionality, and fear of movement (kinesiophobia) in individuals with PFPS. Materials and Methods: Sixty female patients with PFPS participated in this randomized controlled trial. They were randomly assigned to one of three groups: SE, WBE, or SGE. Each program lasted six weeks, with exercises adjusted based on individual tolerance. Outcomes were assessed using the Kujala Anterior Knee Pain Scale, the visual analog scale (VAS) for pain, the Timed Up and Go Test (TUG) for mobility, and the Tampa Kinesiophobia Scale. Results: All groups showed significant improvements in pain, functionality, and kinesiophobia (p < 0.05). The SE group achieved the greatest improvements across all measures, reducing pain and kinesiophobia while enhancing functionality (p < 0.017). The WBE group also showed significant improvements, outperforming the SGE group in all outcomes (p < 0.017). The SGE group demonstrated the least improvement but still achieved positive changes. Conclusions: Supervised exercise programs were the most effective in managing PFPS symptoms. However, the web-based programs also provided substantial benefits, making them a viable option when in-person supervision is not feasible. Future research should aim to enhance digital interventions for broader accessibility and engagement. Trial Registration: The study protocol was also registered on ClinicalTrials.gov (NCT06625086). Full article

Introduction: Many orthopedic surgeons recommend ischemic tourniquets during arthroscopic anterior cruciate ligament (ACL) repair to reduce blood loss and improve visibility. However, their use remains controversial due to potential complications. Similarly, the practice of postoperative drainage is debated. While its proponents argue it reduces limb swelling, DVT, adhesions, and stiffness, others contend that it may increase infection risk or harm the ACL graft and joint surfaces. Materials and Methods: A total of 456 patients underwent anterior cruciate ligament reconstruction between September 2015 and December 2024, without the use of a tourniquet or drainage. The patients were 334 men with a mean age of 34.7 years and 122 women with a mean age of 32.3 years. In 389 cases the graft type was a hamstring autograft, in 55 cases a patellar tendon autograft (BPTB) was used, and in 12 cases a quadriceps tendon autograft was used. Results: The mean operative time was 61 min (range 52–79). No cases experienced visual impairment or required ischemia to enhance visibility. Bleeding sites were successfully cauterized during arthroscopy. Postoperative complications included knee hematoma in three patients (0.7%), resolved after drainage on day one, and two infections (0.4%), treated successfully with arthroscopic drainage and implant removal. No further complications were reported. Conclusion: Although many orthopedic surgeons prefer arthroscopic ACL repair with a tourniquet for better visibility and reduced intraoperative blood loss, this approach carries risks such as nerve palsy, joint swelling, stiffness, muscle weakness, and vascular changes. Not using a tourniquet can help to identify bleeding sites and allows for a more thorough procedure. The literature suggests that avoiding a tourniquet also reduces postoperative pain and accelerates recovery. The mean operative time for ACL reconstruction was consistent with the literature, indicating that avoiding a tourniquet did not cause delays. Additionally, the absence of postoperative drainage did not lead to complications, with most patients showing no issues like bleeding, hematoma, ischemia, or poor wound healing. Full article

Background/Objectives: Hip abductor weakness is a common issue in patients with lower back pain, knee osteoarthritis, and hip disorders, and compromises pelvic stability, gait control, and function. Side-lying hip abduction exercises are widely used as safe and effective interventions for patients unable to perform high-load or weight-bearing activities. However, the influence of ankle joint angles and distal muscle activity on the hip abductor muscles remains unclear. This study aimed to investigate the effects of ankle joint angles and activation states on unilateral right hip abductor strength and muscle activity. Methods: Fifteen healthy male adults (29.1 ± 5.4 years) participated. Surface electromyography (EMG) was used to measure the activity of the tensor fasciae latae (TFL), gluteus medius (G-med), gluteus maximus, tibialis anterior, and medial gas-trocnemius muscles. Hip abduction strength was evaluated in a side-lying position with the ankle positioned at three angles (neutral, dorsiflexion, and plantarflexion) and in three activation states (no activation, maximal dorsiflexion, and maximal plantarflexion). Two-factor (3 × 3) repeated measures ANOVA was used to analyze strength and EMG activity. Results: ANOVA revealed a significant interaction effect. The results of the simple main effects showed significantly higher hip abduction strength in dorsiflexion than in the neutral position and plantarflexion (p < 0.001). TFL and G-med EMG activities peaked during dorsiflexion, particularly under maximal dorsiflexion. Conclusions: These findings suggest that dorsiflexion enhances hip abductor strength and activity by increasing fascial tension (lateral line and superficial backline) and improving limb alignment. This approach may provide effective rehabilitation strategies. This is a load-adjustable training recovery approach that should be confirmed with future intervention studies. Full article