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Published in: Sports Medicine 5/2020

01-05-2020 | Osteoarthrosis | Systematic Review

Tensor Fascia Latae Muscle Structure and Activation in Individuals With Lower Limb Musculoskeletal Conditions: A Systematic Review and Meta-Analysis

Authors: Manuela Besomi, Liam Maclachlan, Rebecca Mellor, Bill Vicenzino, Paul W. Hodges

Published in: Sports Medicine | Issue 5/2020

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Abstract

Background

Dysfunction of the tensor fascia latae (TFL) muscle is often clinically implicated in many musculoskeletal disorders.

Objective

To systematically review the literature of the TFL muscle to determine whether there are differences in its structure and activation between individuals with and without lower limb musculoskeletal conditions.

Data sources

A comprehensive search in MEDLINE, EMBASE, CINHAL, and LILACS was undertaken from year of inception to 9 July 2019.

Eligibility criteria for selecting studies

Studies that directly investigated the structure or activity of the TFL muscle between individuals with a lower limb musculoskeletal condition and a pain-free control group.

Results

Seventeen studies were included (n = 556 participants), eight reporting structure and ten activation of the TFL muscle. Conditions included lateral hip pain, hip joint pathology, ACL injury, iliotibial band syndrome, and patellofemoral joint osteoarthritis. Meta-analysis identified with low confidence (p value = 0.07) a small tendency towards hypertrophy in the affected side of participants with hip joint diseases (SMD 0.37, 95% CI [− 0.02, 0.77]). Moderate effect sizes were found for a higher cross-sectional area of the TFL/sartorius ratio in abductor tendon tear (SMD 0.74; 95% CI [0.05, 1.43, p value = 0.04), and for a smaller body mass normalized TFL volume in patellofemoral joint osteoarthritis (SMD − 0.61; 95% CI [− 1.23, 0.00], p value = 0.05). Normalised electromyography (EMG) amplitude did not differ between groups for any condition, but when EMG was analysed as linear envelopes or synergies, some differences in pattern of TFL activation were observed between individuals with lateral hip pain and controls. Timing of TFL activation did not differ between individuals with knee conditions and controls.

Conclusions and implications

Common clinical assumptions of the role of TFL muscle in lower limb musculoskeletal conditions are not well investigated and poorly supported by current research. There are contradictory findings on the muscle size of TFL. Differing methodology in muscle activation studies precludes a clear interpretation for comparison between groups.

PROSPERO registration number

CRD42017076160.
Appendix
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Literature
4.
go back to reference Gottschalk F, Kourosh S, Leveau B. The functional anatomy of tensor fasciae latae and gluteus medius and minimus. J Anat. 1989;166:179–89.PubMedPubMedCentral Gottschalk F, Kourosh S, Leveau B. The functional anatomy of tensor fasciae latae and gluteus medius and minimus. J Anat. 1989;166:179–89.PubMedPubMedCentral
5.
go back to reference Sahrmann S. Diagnosis and treatment of movement impairment syndromes: includes E-book. St Louis, United States: Elsevier Science Health Science Division; 2001. Sahrmann S. Diagnosis and treatment of movement impairment syndromes: includes E-book. St Louis, United States: Elsevier Science Health Science Division; 2001.
12.
go back to reference Gundersen HJG, Bendtsen TF, Korbo L, Marcussen N, Moller A, Nielsen K, Nyengaard JR, Pakkenberg B, Sorensen FB, Vesterby A, West MJ. Some new, simple and efficient stereological methods and their use in pathological research and diagnosis. APMIS. 1988;96(1–6):379–94.CrossRefPubMed Gundersen HJG, Bendtsen TF, Korbo L, Marcussen N, Moller A, Nielsen K, Nyengaard JR, Pakkenberg B, Sorensen FB, Vesterby A, West MJ. Some new, simple and efficient stereological methods and their use in pathological research and diagnosis. APMIS. 1988;96(1–6):379–94.CrossRefPubMed
20.
go back to reference Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.CrossRefPubMed Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.CrossRefPubMed
21.
go back to reference Cohen J. The concepts of power analysis. In: Cohen J, editor. Statistical power analysis for the behavioral sciences. Academic Press; 1977. p. 1–17. Cohen J. The concepts of power analysis. In: Cohen J, editor. Statistical power analysis for the behavioral sciences. Academic Press; 1977. p. 1–17.
28.
go back to reference Arokoski M, Arokoski J, Haara M, et al. Hip muscle strength and muscle cross sectional area in men with and without hip osteoarthritis. J Rheumatol. 2002;29(10):2185–95.PubMed Arokoski M, Arokoski J, Haara M, et al. Hip muscle strength and muscle cross sectional area in men with and without hip osteoarthritis. J Rheumatol. 2002;29(10):2185–95.PubMed
44.
go back to reference Hug F, Tucker K. Surface electromyography to study muscle coordination. In: Müller B, Wolf SI, Brueggemann G-P, Deng Z, McIntosh A, Miller F, et al., editors. Handbook of human motion. Cham: Springer International Publishing; 2017. p. 1–21. Hug F, Tucker K. Surface electromyography to study muscle coordination. In: Müller B, Wolf SI, Brueggemann G-P, Deng Z, McIntosh A, Miller F, et al., editors. Handbook of human motion. Cham: Springer International Publishing; 2017. p. 1–21.
51.
go back to reference Merlo A, Campanini I. Applications in movement and gait analysis. In: Merletti R, Farina D, editors. Surface electromyography: physiology, engineering, and applications. IEEE Press, Wiley: IEEE Press Series on Biomedical Engineering; 2016. p. 440–59.CrossRef Merlo A, Campanini I. Applications in movement and gait analysis. In: Merletti R, Farina D, editors. Surface electromyography: physiology, engineering, and applications. IEEE Press, Wiley: IEEE Press Series on Biomedical Engineering; 2016. p. 440–59.CrossRef
54.
go back to reference Besomi M, Hodges PW, Van Dieën J, Carson RG, Clancy EA, Disselhorst-Klug C, et al. Consensus for experimental design in electromyography (CEDE) project: electrode selection matrix. J Electromyogr Kinesiol. 2019;48:128–44.CrossRefPubMed Besomi M, Hodges PW, Van Dieën J, Carson RG, Clancy EA, Disselhorst-Klug C, et al. Consensus for experimental design in electromyography (CEDE) project: electrode selection matrix. J Electromyogr Kinesiol. 2019;48:128–44.CrossRefPubMed
Metadata
Title
Tensor Fascia Latae Muscle Structure and Activation in Individuals With Lower Limb Musculoskeletal Conditions: A Systematic Review and Meta-Analysis
Authors
Manuela Besomi
Liam Maclachlan
Rebecca Mellor
Bill Vicenzino
Paul W. Hodges
Publication date
01-05-2020
Publisher
Springer International Publishing
Published in
Sports Medicine / Issue 5/2020
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI
https://doi.org/10.1007/s40279-019-01251-1

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