{"id":{"repo_id":"uic","oai_identifier":"oai:figshare.com:article/32995235"},"canonical_url":"https://search.dev.ndltd.org/etd/uic/oai:figshare.com:article/32995235","repository":{"repo_id":"uic","name":"University of Illinois - Chicago","base_url":"https://api.figshare.com/v2/oai"},"display":{"title":"Role of Transverse Plane Hip Range of Motion and Strength on Pain and Function in Hip Osteoarthritis","abstract":"Osteoarthritis (OA) of the hip is a chronic, progressive disease that decreases joint mobility and function and is associated with disability and musculoskeletal pain (Bieler et al., 2017; O’Neill et al., 2018; O’Neill & Felson, 2018; Rydevik et al., 2010). According to the Centers for Disease Control, hip OA affects 1 in 7 adults in the United States (Braun & Gold, 2011; Y. Zhang & Jordan, 2010). Due to musculoskeletal pain and decreased mobility, people with OA are less active, leading to a sedentary lifestyle, higher mortality rates, and a lower overall quality of life. The initial movements to diminish are hip flexion and internal rotation (Cibulka, Strube, et al., 2009; Cibulka et al., 2014) Decreased function and pain are significant concerns in people with hip OA. The literature reports lower extremity muscle weakness, primarily in the knee muscles, with fewer studies examining muscle strength in hip OA (Arokoski, 2002; Hinman et al., 2010; Pua et al., 2009). The hip’s range of motion (ROM) is decreased, particularly in internal rotation, flexion, and abduction. In hip OA, transverse plane ROM and strength are understudied compared with those in the sagittal and frontal planes (Holla et al., 2011; Pua et al., 2009; Y. Zhang & Jordan, 2010). Understanding how transverse strength and ROM of the hip muscles relate to pain and function is necessary. Understanding the association between strength and ROM in the transverse plane may help clinicians develop better, individualized assessments and interventions. Current Osteoarthritis Research Society International exercise guidelines for osteoarthritis are general and inconsistent. The general recommendation is primarily based on knee OA and includes aerobic and strength training, endurance, land or water-based exercises, and joint ROM (Bannuru et al., 2019). Evidence indicates a low-to-moderate effect of exercise versus nonexercise on hip and knee OA. Moreover, aerobic exercise and strengthening programs improved symptoms and joint function (Nguyen, 2016). However, the exercise content is vague and does not specify the mode, intensity, duration, affected joint, or subjects’ comorbidities. Furthermore, most knee OA exercise interventions are applied directly to hip OA. The latest guidelines for hip OA recommend land- or water-based exercise programs to improve ROM, strengthen the hip stabilizers and the trochanteric muscles of the pelvis, and incorporate postural extension exercises to prevent a hip extension deficit that can lead to hip flexion (Holden et al., 2021; Holden, Metcalf, et al., 2023). Despite a lack of scientific evidence, Tai Chi and yoga are recommended for hip OA as safe and effective forms of exercise, based on results from patients with knee OA (Chyu et al., 2011; Uhlig, 2012). Additionally, exercise guidelines are developed from expert clinical experience and indirect evidence and administered in a clinical or home-based setting. To date, guidance on which hip muscles to target in strengthening programs is challenging because the evidence is inconsistent, derived from studies of knee OA, and based on experts’ opinions. Research evidence on strengthening the hip stabilizers shows improved joint stability of the pelvis and the trochanteric muscles, and a decrease in joint load (Rannou & Poiraudeau, 2010). To summarize, current guidelines lack specificity, especially for hip OA, and therefore, there is a need for additional randomized controlled trials to address this gap. An updated summary of the Cochrane review found that land-based exercises, such as traditional strength, aerobics, and functional training, slightly improved function and reduced pain (Fransen et al., 2014). The proposed research is innovative and addresses a knowledge gap in the literature regarding transverse strength, ROM, and how these factors influence pain and function in people with hip OA. In addition, innovative strength testing and weight-bearing ROM testing may provide more accurate measures of functional strength and ROM in people with hip OA. The outcomes of this research will provide the following: (a) an understanding of the role of transverse plane muscle strength and ROM in relation to pain, (b) an understanding of the role of transverse plane muscle strength and ROM in relation to function, and (c) information on transverse ROM values in supine non weight bearing versus weight-bearing in people with hip OA. Establishing new knowledge and testing procedures can lead to better evaluation and examination of these parameters, allowing clinicians to assess patients’ function by mimicking joint motion during activities of daily living. Furthermore, it can guide clinicians in developing hip-focused exercise programs and address the unique functional demands of the hip joint.","abstract_html":"Osteoarthritis (OA) of the hip is a chronic, progressive disease that decreases joint mobility and function and is associated with disability and musculoskeletal pain (Bieler et al., 2017; O’Neill et al., 2018; O’Neill & Felson, 2018; Rydevik et al., 2010). According to the Centers for Disease Control, hip OA affects 1 in 7 adults in the United States (Braun & Gold, 2011; Y. Zhang & Jordan, 2010). Due to musculoskeletal pain and decreased mobility, people with OA are less active, leading to a sedentary lifestyle, higher mortality rates, and a lower overall quality of life. The initial movements to diminish are hip flexion and internal rotation (Cibulka, Strube, et al., 2009; Cibulka et al., 2014) Decreased function and pain are significant concerns in people with hip OA. The literature reports lower extremity muscle weakness, primarily in the knee muscles, with fewer studies examining muscle strength in hip OA (Arokoski, 2002; Hinman et al., 2010; Pua et al., 2009). The hip’s range of motion (ROM) is decreased, particularly in internal rotation, flexion, and abduction. In hip OA, transverse plane ROM and strength are understudied compared with those in the sagittal and frontal planes (Holla et al., 2011; Pua et al., 2009; Y. Zhang & Jordan, 2010). Understanding how transverse strength and ROM of the hip muscles relate to pain and function is necessary. Understanding the association between strength and ROM in the transverse plane may help clinicians develop better, individualized assessments and interventions. Current Osteoarthritis Research Society International exercise guidelines for osteoarthritis are general and inconsistent. The general recommendation is primarily based on knee OA and includes aerobic and strength training, endurance, land or water-based exercises, and joint ROM (Bannuru et al., 2019). Evidence indicates a low-to-moderate effect of exercise versus nonexercise on hip and knee OA. Moreover, aerobic exercise and strengthening programs improved symptoms and joint function (Nguyen, 2016). However, the exercise content is vague and does not specify the mode, intensity, duration, affected joint, or subjects’ comorbidities. Furthermore, most knee OA exercise interventions are applied directly to hip OA. The latest guidelines for hip OA recommend land- or water-based exercise programs to improve ROM, strengthen the hip stabilizers and the trochanteric muscles of the pelvis, and incorporate postural extension exercises to prevent a hip extension deficit that can lead to hip flexion (Holden et al., 2021; Holden, Metcalf, et al., 2023). Despite a lack of scientific evidence, Tai Chi and yoga are recommended for hip OA as safe and effective forms of exercise, based on results from patients with knee OA (Chyu et al., 2011; Uhlig, 2012). Additionally, exercise guidelines are developed from expert clinical experience and indirect evidence and administered in a clinical or home-based setting. To date, guidance on which hip muscles to target in strengthening programs is challenging because the evidence is inconsistent, derived from studies of knee OA, and based on experts’ opinions. Research evidence on strengthening the hip stabilizers shows improved joint stability of the pelvis and the trochanteric muscles, and a decrease in joint load (Rannou & Poiraudeau, 2010). To summarize, current guidelines lack specificity, especially for hip OA, and therefore, there is a need for additional randomized controlled trials to address this gap. An updated summary of the Cochrane review found that land-based exercises, such as traditional strength, aerobics, and functional training, slightly improved function and reduced pain (Fransen et al., 2014). The proposed research is innovative and addresses a knowledge gap in the literature regarding transverse strength, ROM, and how these factors influence pain and function in people with hip OA. In addition, innovative strength testing and weight-bearing ROM testing may provide more accurate measures of functional strength and ROM in people with hip OA. The outcomes of this research will provide the following: (a) an understanding of the role of transverse plane muscle strength and ROM in relation to pain, (b) an understanding of the role of transverse plane muscle strength and ROM in relation to function, and (c) information on transverse ROM values in supine non weight bearing versus weight-bearing in people with hip OA. Establishing new knowledge and testing procedures can lead to better evaluation and examination of these parameters, allowing clinicians to assess patients’ function by mimicking joint motion during activities of daily living. Furthermore, it can guide clinicians in developing hip-focused exercise programs and address the unique functional demands of the hip joint.","abstract_has_math":false,"creators":["Vered Arbel (24400181)"],"institution":null,"degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2026,"date_issued":"2026-05-01T00:00:00Z","date_published":"2026-05-01T00:00:00Z","updated_at":"2026-07-27T21:33:52Z","subjects":["Biomechanics","Exercise","kinesiology","Movement science"],"languages":[],"rights":["In Copyright","Open Access after 2028-05-01"],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://doi.org/10.25417/uic.32995235.v1","outbound_label":"DOI","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["Vered Arbel (24400181)"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2026-05-01T00:00:00Z"]},{"key":"dc:relation","label":"Dc Relation","values":["https://figshare.com/articles/thesis/Role_of_Transverse_Plane_Hip_Range_of_Motion_and_Strength_on_Pain_and_Function_in_Hip_Osteoarthritis/32995235"]},{"key":"dc:type","label":"Dc Type","values":["Text","Thesis"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Biomechanics","Exercise","kinesiology","Movement science"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:rights","label":"Dc Rights","values":["In Copyright","Open Access after 2028-05-01"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["10.25417/uic.32995235.v1"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["Osteoarthritis (OA) of the hip is a chronic, progressive disease that decreases joint mobility and function and is associated with disability and musculoskeletal pain (Bieler et al., 2017; O’Neill et al., 2018; O’Neill & Felson, 2018; Rydevik et al., 2010). According to the Centers for Disease Control, hip OA affects 1 in 7 adults in the United States (Braun & Gold, 2011; Y. Zhang & Jordan, 2010). Due to musculoskeletal pain and decreased mobility, people with OA are less active, leading to a sedentary lifestyle, higher mortality rates, and a lower overall quality of life. The initial movements to diminish are hip flexion and internal rotation (Cibulka, Strube, et al., 2009; Cibulka et al., 2014) Decreased function and pain are significant concerns in people with hip OA. The literature reports lower extremity muscle weakness, primarily in the knee muscles, with fewer studies examining muscle strength in hip OA (Arokoski, 2002; Hinman et al., 2010; Pua et al., 2009). The hip’s range of motion (ROM) is decreased, particularly in internal rotation, flexion, and abduction. In hip OA, transverse plane ROM and strength are understudied compared with those in the sagittal and frontal planes (Holla et al., 2011; Pua et al., 2009; Y. Zhang & Jordan, 2010). Understanding how transverse strength and ROM of the hip muscles relate to pain and function is necessary. Understanding the association between strength and ROM in the transverse plane may help clinicians develop better, individualized assessments and interventions. Current Osteoarthritis Research Society International exercise guidelines for osteoarthritis are general and inconsistent. The general recommendation is primarily based on knee OA and includes aerobic and strength training, endurance, land or water-based exercises, and joint ROM (Bannuru et al., 2019). Evidence indicates a low-to-moderate effect of exercise versus nonexercise on hip and knee OA. Moreover, aerobic exercise and strengthening programs improved symptoms and joint function (Nguyen, 2016). However, the exercise content is vague and does not specify the mode, intensity, duration, affected joint, or subjects’ comorbidities. Furthermore, most knee OA exercise interventions are applied directly to hip OA. The latest guidelines for hip OA recommend land- or water-based exercise programs to improve ROM, strengthen the hip stabilizers and the trochanteric muscles of the pelvis, and incorporate postural extension exercises to prevent a hip extension deficit that can lead to hip flexion (Holden et al., 2021; Holden, Metcalf, et al., 2023). Despite a lack of scientific evidence, Tai Chi and yoga are recommended for hip OA as safe and effective forms of exercise, based on results from patients with knee OA (Chyu et al., 2011; Uhlig, 2012). Additionally, exercise guidelines are developed from expert clinical experience and indirect evidence and administered in a clinical or home-based setting. To date, guidance on which hip muscles to target in strengthening programs is challenging because the evidence is inconsistent, derived from studies of knee OA, and based on experts’ opinions. Research evidence on strengthening the hip stabilizers shows improved joint stability of the pelvis and the trochanteric muscles, and a decrease in joint load (Rannou & Poiraudeau, 2010). To summarize, current guidelines lack specificity, especially for hip OA, and therefore, there is a need for additional randomized controlled trials to address this gap. An updated summary of the Cochrane review found that land-based exercises, such as traditional strength, aerobics, and functional training, slightly improved function and reduced pain (Fransen et al., 2014). The proposed research is innovative and addresses a knowledge gap in the literature regarding transverse strength, ROM, and how these factors influence pain and function in people with hip OA. In addition, innovative strength testing and weight-bearing ROM testing may provide more accurate measures of functional strength and ROM in people with hip OA. The outcomes of this research will provide the following: (a) an understanding of the role of transverse plane muscle strength and ROM in relation to pain, (b) an understanding of the role of transverse plane muscle strength and ROM in relation to function, and (c) information on transverse ROM values in supine non weight bearing versus weight-bearing in people with hip OA. Establishing new knowledge and testing procedures can lead to better evaluation and examination of these parameters, allowing clinicians to assess patients’ function by mimicking joint motion during activities of daily living. Furthermore, it can guide clinicians in developing hip-focused exercise programs and address the unique functional demands of the hip joint."]},{"key":"dc:title","label":"Title","values":["Role of Transverse Plane Hip Range of Motion and Strength on Pain and Function in Hip Osteoarthritis"]}]}],"canonical_facts":{"dc:creator":["Vered Arbel (24400181)"],"dc:date":["2026-05-01T00:00:00Z"],"dc:description":["Osteoarthritis (OA) of the hip is a chronic, progressive disease that decreases joint mobility and function and is associated with disability and musculoskeletal pain (Bieler et al., 2017; O’Neill et al., 2018; O’Neill & Felson, 2018; Rydevik et al., 2010). According to the Centers for Disease Control, hip OA affects 1 in 7 adults in the United States (Braun & Gold, 2011; Y. Zhang & Jordan, 2010). Due to musculoskeletal pain and decreased mobility, people with OA are less active, leading to a sedentary lifestyle, higher mortality rates, and a lower overall quality of life. The initial movements to diminish are hip flexion and internal rotation (Cibulka, Strube, et al., 2009; Cibulka et al., 2014) Decreased function and pain are significant concerns in people with hip OA. The literature reports lower extremity muscle weakness, primarily in the knee muscles, with fewer studies examining muscle strength in hip OA (Arokoski, 2002; Hinman et al., 2010; Pua et al., 2009). The hip’s range of motion (ROM) is decreased, particularly in internal rotation, flexion, and abduction. In hip OA, transverse plane ROM and strength are understudied compared with those in the sagittal and frontal planes (Holla et al., 2011; Pua et al., 2009; Y. Zhang & Jordan, 2010). Understanding how transverse strength and ROM of the hip muscles relate to pain and function is necessary. Understanding the association between strength and ROM in the transverse plane may help clinicians develop better, individualized assessments and interventions. Current Osteoarthritis Research Society International exercise guidelines for osteoarthritis are general and inconsistent. The general recommendation is primarily based on knee OA and includes aerobic and strength training, endurance, land or water-based exercises, and joint ROM (Bannuru et al., 2019). Evidence indicates a low-to-moderate effect of exercise versus nonexercise on hip and knee OA. Moreover, aerobic exercise and strengthening programs improved symptoms and joint function (Nguyen, 2016). However, the exercise content is vague and does not specify the mode, intensity, duration, affected joint, or subjects’ comorbidities. Furthermore, most knee OA exercise interventions are applied directly to hip OA. The latest guidelines for hip OA recommend land- or water-based exercise programs to improve ROM, strengthen the hip stabilizers and the trochanteric muscles of the pelvis, and incorporate postural extension exercises to prevent a hip extension deficit that can lead to hip flexion (Holden et al., 2021; Holden, Metcalf, et al., 2023). Despite a lack of scientific evidence, Tai Chi and yoga are recommended for hip OA as safe and effective forms of exercise, based on results from patients with knee OA (Chyu et al., 2011; Uhlig, 2012). Additionally, exercise guidelines are developed from expert clinical experience and indirect evidence and administered in a clinical or home-based setting. To date, guidance on which hip muscles to target in strengthening programs is challenging because the evidence is inconsistent, derived from studies of knee OA, and based on experts’ opinions. Research evidence on strengthening the hip stabilizers shows improved joint stability of the pelvis and the trochanteric muscles, and a decrease in joint load (Rannou & Poiraudeau, 2010). To summarize, current guidelines lack specificity, especially for hip OA, and therefore, there is a need for additional randomized controlled trials to address this gap. An updated summary of the Cochrane review found that land-based exercises, such as traditional strength, aerobics, and functional training, slightly improved function and reduced pain (Fransen et al., 2014). The proposed research is innovative and addresses a knowledge gap in the literature regarding transverse strength, ROM, and how these factors influence pain and function in people with hip OA. In addition, innovative strength testing and weight-bearing ROM testing may provide more accurate measures of functional strength and ROM in people with hip OA. The outcomes of this research will provide the following: (a) an understanding of the role of transverse plane muscle strength and ROM in relation to pain, (b) an understanding of the role of transverse plane muscle strength and ROM in relation to function, and (c) information on transverse ROM values in supine non weight bearing versus weight-bearing in people with hip OA. Establishing new knowledge and testing procedures can lead to better evaluation and examination of these parameters, allowing clinicians to assess patients’ function by mimicking joint motion during activities of daily living. Furthermore, it can guide clinicians in developing hip-focused exercise programs and address the unique functional demands of the hip joint."],"dc:identifier":["10.25417/uic.32995235.v1"],"dc:relation":["https://figshare.com/articles/thesis/Role_of_Transverse_Plane_Hip_Range_of_Motion_and_Strength_on_Pain_and_Function_in_Hip_Osteoarthritis/32995235"],"dc:rights":["In Copyright","Open Access after 2028-05-01"],"dc:subject":["Biomechanics","Exercise","kinesiology","Movement science"],"dc:title":["Role of Transverse Plane Hip Range of Motion and Strength on Pain and Function in Hip Osteoarthritis"],"dc:type":["Text","Thesis"]},"updated_at":"2026-07-27T21:33:52Z"}