The deep hip muscles are unlikely to contribute to hip stability in the sagittal plane during walking: a stiffness approach.

Abstract - Objective: This study determined whether the deep hip muscles could contribute to hip stability. Methods: Hip stability was defined as rotational hip stiffness in the sagittal plane, which was calculated for walking trials for 12 participants via electromyography (EMG)informed neuromusculoskeletal modelling that included all 22 hip spanning muscles. Three model configurations were compared that differed in the excitations of the deep hip muscles, but were identical in the excitations of all other muscles: (1) deep hip muscles informed by intramuscular EMG measurements (assisted activation); (2) deep hip muscles with simulated zero activation (no activation); (3) deep hip muscles with simulated maximal activation (maximal activation). Sagittal plane rotational hip stiffness over the gait cycle was compared between model configurations using a within-participant analysis of variance via statistical parametric mapping (p<0.05). Results: Compared to the assisted activation configuration, hip stiffness (mean (95% confidence interval)) was 0.8% (0.7 to 0.9) lower in the no activation configuration, and 3.2% (2.9 to 3.5) higher in the maximal activation configuration over the gait cycle. Conclusion: Regardless of activation level, the deep hip muscles made little contribution to sagittal plane rotational hip stiffness, which casts uncertainty around their assumed function as hip stabilizers. Significance: The merit of targeted deep hip muscle strengthening to improve hip stability in rehabilitation programs for remains unclear.