Systematic Review of the Importance of Hip Muscle Strength, Activation, and Structure in Balance and Mobility Tasks.
Marcel B Lanza, Breanna Arbuco, Alice S Ryan and 3 others
PMID 34998714WHAT IT FOUND
Stronger hip abductors generally mean better balance and mobility in young and older adults, but not always in middle-aged groups.
Higher fat inside the gluteus medius muscle is linked to falls in older adults. Activation timing varies by age and task.
Key findings
01Young and older adults with higher hip abduction torque perform better during balance and mobility tasks, whereas hip abduction torque appears to play less of a role in middle-aged adults.
02Older fallers have higher intramuscular fat in the gluteus medius than nonfallers, whereas fat content in the tensor fasciae latae does not differ between these groups.
03During balance perturbations, a lateral step requires greater hip abductor neuromuscular activation compared with other step types across all age groups.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review is based on cross-sectional studies, so it shows associations but cannot prove that hip weakness or structure causes balance problems. There was extreme variation in how balance and mobility were measured across studies (e.g., YBT, TUG, perturbation platforms), making direct comparisons difficult. Middle-aged adults were underrepresented in the studies, limiting conclusions for this group. Only 5 studies examined muscle structure, all in older adults. Most studies measured hip strength in isolation (isometric) rather than during functional balance tasks. The narrative synthesis means no overall effect sizes or pooled statistics are available.
Declared interests
No specific conflicts of interest or funding declarations were included in the provided text.
The easy way to misread this
Do not assume that strengthening hip abductors will directly improve balance or prevent falls. This review only shows that hip strength and structure are associated with balance performance in cross-sectional studies; it did not test any training interventions.