Volume 8, Issue 1 (Spring 2018)                   PTJ 2018, 8(1): 27-36 | Back to browse issues page


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Mozafaripour E, Rajabi R, Minoonejad H. Anatomical Alignment of Lower Extremity in Subjects With Genu Valgum and Genu Varum Deformities. PTJ 2018; 8 (1) :27-36
URL: http://ptj.uswr.ac.ir/article-1-351-en.html
1- Department of Sports Medicine and Health, Faculty of Physical Education & Sport Sciences, University of Tehran, Tehran, Iran.
Abstract:   (6827 Views)
Purpose: Changes in lower extremity alignment in individuals with abnormality of this segments are unclear. The present study aimed to compare lower extremity alignment in subjects with genu valgum and genu varum deformities and healthy subjects  in order to understand the lower extremity alignment changes in this group. 
Methods: This was a causal-comparative study. The sample comprised 120 males selected by convenience sampling method. In total, 40 subjects were assigned to genu valgum group, 40 to genu varum group, and 40 to healthy subject group. Lower extremity alignment was evaluated in anteversion of hip, Q angle, internal and external rotation of hip, knee hyperextension, tibial torsion, tibia vara, and foot arch index, at the laboratory of Tehran University, Tehran, Iran. To compare the mean score of variables between the groups, 1-way Analysis of Variance (ANOVA) was used. The obtained data were analyzed by SPSS. 
Results: The internal rotation of hip, Q angle, anteversion of hip, knee hyperextension and plantar arch index were significantly higher in the subjects with genu valgum deformity, compared to the subjects with genu varum deformity. The tibia vara value was significantly higher in the subjects with genu varum deformity than those with genu valgum deformity. However, no significant differences was found between the tibial torsion and external rotation of hip in the study groups. 
Conclusion: The lower extremity alignment changes in the subjects with genu valgum deformity included increased anteversion, Q angle, flatfoot, knee hyperextension, and internal rotation of the hip. Also, the changes in the subjects with genu varum deformity included decreased Q angle, internal rotation of hip, knee hyperextension, but increased tibia vara, and foot arch.
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Type of Study: Applicable | Subject: General
Received: 2018/06/1 | Accepted: 2018/10/13 | Published: 2019/02/19

References
1. Hertel J, Dorfman JH, Braham RA. Lower extremity malalignments and anterior cruciate ligament injury history. Journal of Sports Science & Medicine. 2004; 3(4):220-5. [PMID] [PMCID] [PMID] [PMCID]
2. Powers CM, Chen PY, Reischl SF, Perry J. Comparison of foot pronation and lower extremity rotation in persons with and without patellofemoral pain. Foot & Ankle International. 2002; 23(7):634-40. [DOI:10.1177/107110070202300709] [PMID] [DOI:10.1177/107110070202300709]
3. Shultz SJ, Carcia CR, Gansneder BM, Perrin DH. The independent and interactive effects of navicular drop and quadriceps angle on neuromuscular responses to a weight-bearing perturbation. Journal of Athletic Training. 2006; 41(3):251-9. [PMID] [PMCID] [PMID] [PMCID]
4. Meyer EG, Haut RC. Anterior cruciate ligament injury induced by internal tibial torsion or tibiofemoral compression. Journal of Biomechanics. 2008; 41(16):3377-83. [DOI:10.1016/j.jbiomech.2008.09.023] [PMID] [DOI:10.1016/j.jbiomech.2008.09.023]
5. Kaneko M, Sakuraba K. Association between femoral anteversion and lower extremity posture upon single-leg landing: Implications for anterior cruciate ligament injury. Journal of Physical Therapy Science. 2013; 25(10):1213-7. [DOI:10.1589/jpts.25.1213] [PMID] [PMCID] [DOI:10.1589/jpts.25.1213]
6. Bonci CM. Assessment and evaluation of predisposing factors to anterior cruciate ligament injury. Journal of Athletic Training. 1999; 34(2):155-64. [PMID] [PMCID] [PMID] [PMCID]
7. Nyland J, Kuzemchek S, Parks M, Caborn DN. Femoral anteversion influences vastus medialis and gluteus medius EMG amplitude: Composite hip abductor EMG amplitude ratios during isometric combined hip abduction-external rotation. Journal of Electromyography and Kinesiology. 2004; 14(2):255-61. [DOI:10.1016/S1050-6411(03)00078-6] [DOI:10.1016/S1050-6411(03)00078-6]
8. Amraee D, Alizadeh MH, Razi M, Yazdi HR, Minoonejad H. Risk factors associated with noncontact injuries of the anterior cruciate ligament in male athletes. Minerva Ortopedica e Traumatologica. 2013; 64(4):435-44.
9. Sahrmann S. Movement system impairment syndromes of the extremities, cervical and thoracic spines. Amsterdam: Elsevier Health Sciences; 2011.
10. Levangie PK, Norkin CC. Joint structure and function: A comprehensive analysis. Philadelphia, Pennsylvania: FA Davis; 2011. [PMID] [PMID]
11. Neumann DA. Kinesiology of the musculoskeletal system-e-book: Foundations for rehabilitation. Amsterdam: Elsevier Health Sciences; 2013.
12. Papaioannou T, Stokes I, Kenwright J. Scoliosis associated with limb-length inequality. Journal of Bone and Joint Surgery. 1982; 64(1):59-62. [DOI:10.2106/00004623-198264010-00009] [PMID] [DOI:10.2106/00004623-198264010-00009]
13. Steen H, Terjesen T, Bjerkreim I. [Anisomelia: Clinical consequences and treatment (Danish)]. Journal for the Norwegian Medical Association: Journal for Practical Medicine, New Series. 1997; 117(11):1595-600.
14. Samaei A, Bakhtiary AH, Elham F, Rezasoltani A. Effects of genu varum deformity on postural stability. International Journal of Sports Medicine. 2012; 33(06):469-73. [DOI:10.1055/s-0031-1301331] [PMID] [DOI:10.1055/s-0031-1301331]
15. Palastanga N, Field D, Soames R. Anatomy and human movement: Structure and function. Amsterdam: Elsevier Health Sciences; 2006.
16. Piva SR, Fitzgerald K, Irrgang JJ, Jones S, Hando BR, Browder DA, et al. Reliability of measures of impairments associated with patellofemoral pain syndrome. BMC Musculoskeletal Disorders. 2006; 7(1):33. [DOI:10.1186/1471-2474-7-33] [PMID] [PMCID] [DOI:10.1186/1471-2474-7-33]
17. Emami MJ, Ghahramani MH, Abdinejad F, Namazi H. Q-angle: An invaluable parameter for evaluation of anterior knee pain. Archives of Iranian Medicine. 2007; 10(1):24-6. [PMID] [PMID]
18. Greene CC, Edwards TB, Wade MR, Carson EW. Reliability of the quadriceps angle measurement. The American Journal of Knee Surgery. 2001; 14(2):97-103. [PMID] [PMID]
19. Loudon JK. Measurement of knee-joint-position sense in women with genu recurvatum. Journal of Sport Rehabilitation. 2000; 9(1):15-25. [DOI:10.1123/jsr.9.1.15] [DOI:10.1123/jsr.9.1.15]
20. Kwon OY, Tuttle LJ, Commean PK, Mueller MJ. Reliability and validity of measures of hammer toe deformity angle and tibial torsion. The Foot. 2009; 19(3):149-55. [DOI:10.1016/j.foot.2009.03.004] [PMID] [PMCID] [DOI:10.1016/j.foot.2009.03.004]
21. Lee SH, Chung CY, Park MS, Choi IH, Cho TJ. Tibial torsion in cerebral palsy: Validity and reliability of measurement. Clinical Orthopaedics and Related Research. 2009; 467(8):2098-104. [DOI:10.1007/s11999-009-0705-1] [PMID] [PMCID] [DOI:10.1007/s11999-009-0705-1]
22. Lohmann KN, Rayhel HE, Schneiderwind WP, Danoff JV. Static measurement of tibia vara: Reliability and effect of lower extremity position. Physical Therapy. 1987; 67(2):196-9. [DOI:10.1093/ptj/67.2.196] [PMID] [DOI:10.1093/ptj/67.2.196]
23. Staheli LT, Chew DE, Corbett MA. The longitudinal arch: A survey of eight hundred and eighty-two feet in normal children and adults. The Journal of Bone and Joint Surgery; American Volume. 1987; 69(3):426-8. [PMID] [DOI:10.2106/00004623-198769030-00014] [PMID]
24. Tönnis D, Heinecke A. Acetabular and femoral anteversion: Relationship with osteoarthritis of the hip. The Journal of Bone and Joint Surgery. 1999; 81(12):1747-70. [DOI:10.2106/00004623-199912000-00014] [PMID] [DOI:10.2106/00004623-199912000-00014]
25. Magee DJ. Orthopedic physical assessment. Amsterdam: Elsevier Health Sciences; 2008.
26. Lawrence III RK, Kernozek TW, Miller EJ, Torry MR, Reuteman P. Influences of hip external rotation strength on knee mechanics during single-leg drop landings in females. Clinical Biomechanics. 2008; 23(6):806-13. [DOI:10.1016/j.clinbiomech.2008.02.009] [PMID] [DOI:10.1016/j.clinbiomech.2008.02.009]
27. Nguyen AD, Shultz SJ, Schmitz RJ, Luecht RM, Perrin DH. A preliminary multifactorial approach describing the relationships among lower extremity alignment, hip muscle activation, and lower extremity joint excursion. Journal of Athletic Training. 2011; 46(3):246-56. [DOI:10.4085/1062-6050-46.3.246] [PMID] [PMCID] [DOI:10.4085/1062-6050-46.3.246]
28. Bell DR, Oates DC, Clark MA, Padua DA. Two-and 3-dimensional knee valgus are reduced after an exercise intervention in young adults with demonstrable valgus during squatting. Journal of Athletic Training. 2013; 48(4):442-9. [DOI:10.4085/1062-6050-48.3.16] [PMID] [PMCID] [DOI:10.4085/1062-6050-48.3.16]
29. Frank C, Page P, Lardner R. Assessment and treatment of muscle imbalance: The Janda approach. Champaign, Illinois: Human kinetics; 2009.
30. Bell DR, Padua DA, Clark MA. Muscle strength and flexibility characteristics of people displaying excessive medial knee displacement. Archives of Physical Medicine and Rehabilitation. 2008; 89(7):1323-8. [DOI:10.1016/j.apmr.2007.11.048] [PMID] [DOI:10.1016/j.apmr.2007.11.048]
31. Shamberger W. The malalignment syndrome: Implications for medicine and sport. Amsterdam: Elsevier Health Sciences; 2012.
32. Riegger-Krugh C, Keysor JJ. Skeletal malalignments of the lower quarter: Correlated and compensatory motions and postures. Journal of Orthopaedic & Sports Physical Therapy. 1996; 23(2):164-70. [DOI:10.2519/jospt.1996.23.2.164] [PMID] [DOI:10.2519/jospt.1996.23.2.164]
33. Thompson GH, Carter JR. Late-onset tibia vara (Blount's disease); Current concepts. Clinical Orthopaedics and Related Research. 1990; 255:24-35. [PMID] [PMID]
34. Beskin JL, Burke SW, Johnston CE, Roberts JM. Clinical basis for a mechanical etiology in adolescent Blount's disease. Orthopedics. 1986; 9(3):365-70. [PMID] [PMID]
35. Henderson RC, Greene WB. Etiology of late-onset tibia vara: Is varus alignment a prerequisite. Journal of Pediatric Orthopedics. 1994; 14(2):143-6. [DOI:10.1097/01241398-199403000-00002] [PMID] [DOI:10.1097/01241398-199403000-00002]
36. Lubani MM, Al-Shab TS, Al-Saleh QA, Sharda DC, Quattawi SA, Ahmed SA, et al. Vitamin-D-deficiency rickets in Kuwait: the prevalence of a preventable disease. Annals of Tropical Paediatrics. 1989; 9(3):134-9. [DOI:10.1080/02724936.1989.11748616] [PMID] [DOI:10.1080/02724936.1989.11748616]

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