scholarly journals Lower extremity kinematic coupling during single and double leg landing and gait in female junior athletes with dynamic knee valgus

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Mahdis Dadfar ◽  
Rahman Sheikhhoseini ◽  
Mohadeseh Jafarian ◽  
Alireza Esmaeili
Keyword(s):  
Lower Extremity ◽  
External Rotation ◽  
Knee Valgus ◽  
Physically Active ◽  
Vector Coding ◽  
Junior Athletes ◽  
Kinematic Relationship ◽  
Coupling Strengths ◽  
Joint Motions ◽  
Rearfoot Eversion

Abstract Background Dynamic knee valgus (DKV) is a common lower extremity movement disorder among females. This study aimed to investigate kinematic couplings between lower extremity joints in female junior athletes with DKV during single and double-leg landing and gait. Methods Twenty-six physically active female junior athletes (10–14 years old) with DKV were recruited. Kinematic couplings between rearfoot, tibia, knee, and hip were extracted using eight Vicon motion capture cameras and two force plates. Zero-lag cross-correlation coefficient and vector coding were used to calculate kinematic couplings between joints during physical tasks. Paired t-test and Wilcoxon tests were run to find significant couplings between joint motions and coupling strengths. Bonferroni posthoc was used to determine significance with α ≤ 0.05. Results The results showed that the strongest kinematic relationship existed between rearfoot eversion/inversion and tibial internal/external rotation during all three tasks. Correlations of the rearfoot supination/pronation with tibial rotations, knee, and hip motions in sagittal, frontal, and transverse planes were very strong to strong during double-leg landing and moderate to weak during gait. A weak correlation was observed between rearfoot supination/pronation and hip adduction/abduction during single-leg landing. Conclusions Coupling relationships between rearfoot, knee, and hip vary by the task intensity and alignment profiles in female juniors with DKV.

Relationship of Knee Motions With Static Leg Alignments and Hip Motions in Frontal and Transverse Planes During Double-Leg Landing in Healthy Athletes

2017 ◽  
Vol 26 (5) ◽  
pp. 396-405 ◽  
Author(s):  
Shogo Uota ◽  
Anh-Dung Nguyen ◽  
Naoko Aminaka ◽  
Yohei Shimokochi
Keyword(s):  
Lower Extremity ◽  
Outcome Measures ◽  
External Rotation ◽  
Weight Bearing ◽  
Patellofemoral Pain ◽  
Transverse Plane ◽  
Knee Valgus ◽  
Chronic Knee Pain ◽  
Lower Extremity Alignment ◽  
Peak Knee

Context:Excessive knee valgus and tibial external rotation relative to the femur during weight bearing motions, such as jump-landing, reportedly increases the risk of developing chronic knee pain, such as patellofemoral pain. Excessive deviations from normal ranges of several static lower extremity alignment measures and dynamic hip motions may also increase the risks for patellofemoral pain.Objective:To determine the relationship between lower extremity alignments and hip motions to frontal and transverse plane knee motions during double-leg landings.Design:Correlational study.Setting:Laboratory.Patients or Other Participants:69 healthy, competitive athletes (27 men, 42 women; height, 166.5 ± 9.5 cm; weight, 61.3 ± 9.9 kg; age, 20.7 ± 1.0 y) participated in this study.Interventions:Prone and supine hip version, quadriceps angle, and tibiofemoral angle were measured. Frontal and transverse knee and hip angles at peak knee extensor moment during landing were calculated.Main Outcome Measures:2 separate stepwise multiple regression analyses were conducted to predict frontal and transverse plane knee motions using 4 static lower extremity alignment measures and hip motions.Results:Greater hip adduction and prone hip anteversion, and lesser hip internal rotation and supine hip anteversion, were related to greater knee valgus motions (R2 = .475, P < .01). Greater hip adduction was related to greater knee external rotation (R2 = .205, P < .01).Conclusions:Some targeted static lower extremity alignments and hip motions are associated with frontal and transverse knee motions. However, stronger relationships of hip motions with knee motions than static lower extremity alignments provided evidence that improving hip movements may help improve patellofemoral pain in those with lower extremity malalignments.

Hip and ankle strength and range of motion in female soccer players with dynamic knee valgus

2021 ◽  
pp. 1-6
Author(s):  
Young Jin Jo ◽  
Young Kyun Kim
Keyword(s):  
Range Of Motion ◽  
Female Athletes ◽  
External Rotation ◽  
Preventive Measure ◽  
Control Group ◽  
Knee Valgus ◽  
Strength Ratio ◽  
Flexion Extension ◽  
Hip Abduction ◽  
Single Leg Squat

BACKGROUND: Dynamic knee valgus (DKV) is a known risk factor for acute and chronic knee injuries and is more frequently diagnosed in females. A real-time single-leg squat test (SLST) could screen for DKV to prevent injuries. OBJECTIVE: To compare the differences in lower extremity strength and range of motion (ROM) in female soccer athletes with and without DKV during an SLST. METHODS: Eighteen subjects with DKV (DKV group) and 18 subjects without DKV (control group) during a single-leg squat were included. Hip strength (flexion, extension, abduction, adduction, internal rotation, and external rotation) was measured with a hand-held dynamometer. Hip ROM (internal and external rotation), and ankle ROM (dorsiflexion with the knee flexed and extended) were measured. Independent t-test was used to compare the averages of the groups. RESULTS: There were significant differences in hip abduction to adduction strength ratio (DKV: 1.48 ± 0.3, control: 1.22 ± 0.26, p< 0.01) and ankle dorsiflexion with knee flexed (DKV: 17.22 ± 6.82, control: 21.22 ± 4.55, p< 0.05) and extended (DKV: 10.14 ± 4.23, control: 14.75 ± 3.40, p< 0.001) between the groups. CONCLUSION: The hip abduction to adduction strength ratio and gastrocnemius and soleus flexibility may be associated factors in dynamic knee valgus and therefore should be assessed and treated, if indicated, as a possible preventive measure in female athletes with this variation.

Influence of knee valgus alignment on lower extremity kinematics during level walking

Physiotherapy ◽  
2015 ◽  
Vol 101 ◽  
pp. e213-e214
Author(s):  
F.-H. Chang ◽  
K.-T. Huang ◽  
W.-Y. Chen ◽  
Y.-F. Shih
Keyword(s):  
Lower Extremity ◽  
Knee Valgus ◽  
Level Walking ◽  
Valgus Alignment

scholarly journals Passive Hip Range-of-Motion Values Across Sex and Sport

2018 ◽  
Vol 53 (6) ◽  
pp. 560-567 ◽  
Author(s):  
Jennifer A. Hogg ◽  
Randy J. Schmitz ◽  
Anh-Dung Nguyen ◽  
Sandra J. Shultz
Keyword(s):  
Range Of Motion ◽  
Repeated Measures ◽  
National Collegiate Athletic Association ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Knee Valgus ◽  
Cross Sectional ◽  
Increased Risk ◽  
Hip Range Of Motion ◽  
Cross Country

Context:  Greater passive hip range of motion (ROM) has been associated with greater dynamic knee valgus and thus the potential for increased risk of anterior cruciate ligament injuries. Normative data for passive hip ROM by sex are lacking. Objective:  To establish and compare passive hip ROM values by sex and sport and to quantify side-to-side differences in internal-rotation ROM (ROMIR), external-rotation ROM (ROMER), and total ROM (ROMTOT). Design:  Cross-sectional study. Setting:  Station-based, preparticipation screening. Patients or Other Participants:  A total of 339 National Collegiate Athletic Association Division I athletes, consisting of 168 women (age = 19.2 ± 1.2 years, height = 169.0 ± 7.2 cm, mass = 65.3 ± 10.2 kg) and 171 men (age = 19.4 ± 1.3 years, height = 200.0 ± 8.6 cm, mass = 78.4 ± 12.0 kg) in 6 sports screened over 3 years: soccer (58 women, 67 men), tennis (20 women, 22 men), basketball (28 women, 22 men), softball or baseball (38 women, 31 men), cross-country (18 women, 19 men), and golf (6 women, 10 men). Main Outcome Measure(s):  Passive hip ROM was measured with the athlete lying prone with the hip abducted to 20° to 30° and knee flexed to 90°. The leg was passively internally and externally rotated until the point of sacral movement. Three measures were averaged for each direction and leg and used for analysis. We compared ROMIR, ROMER, ROMTOT (ROMTOT = ROMIR + ROMER), and relative ROM (ROMREL = ROMIR − ROMER) between sexes and among sports using separate 2 × 6 repeated-measures analyses of variance. Results:  Women had greater ROMIR (38.1° ± 8.2° versus 28.6° ± 8.4°; F1,327 = 91.74, P &lt; .001), ROMTOT (72.1° ± 10.6° versus 64.4° ± 10.1°; F1,327 = 33.47, P &lt; .001), and ROMREL (1.5° ± 16.0° versus −7.6° ± 16.5°; F1,327 = 37.05, P &lt; .001) than men but similar ROMER (34.0° ± 12.2° versus 35.8° ± 11.5°; F1,327 = 1.65, P = .20) to men. Cross-country athletes exhibited greater ROMIR (37.0° ± 9.3° versus 30.9° ± 9.4° to 33.3° ± 9.5°; P = .001) and ROMREL (5.9° ± 18.3° versus −9.6° ± 16.9° to −2.7° ± 17.3°; P = .001) and less ROMER (25.7° ± 7.5° versus 35.0° ± 13.0° to 40.2° ± 12.0°; P &lt; .001) than basketball, soccer, softball or baseball, and tennis athletes. They also displayed less ROMTOT (62.7° ± 8.1° versus 70.0° ± 9.1° to 72.9° ± 11.9°; P &lt; .001) than basketball, softball or baseball, and tennis athletes. Conclusions:  Women had greater ROMIR than men, resulting in greater ROMTOT and ROMREL. Researchers should examine the extent to which this greater bias toward ROMIR may explain women's greater tendency for dynamic knee valgus. With the exception of cross-country, ROM values were similar across sports. The clinical implications of these aberrant cross-country values require further study.

Upper Extremity and Hip Range of Motion Changes Throughout a Season in Professional Baseball Players

2019 ◽  
Vol 48 (2) ◽  
pp. 481-487
Author(s):  
Justin M. Chan ◽  
John Zajac ◽  
Brandon J. Erickson ◽  
David W. Altchek ◽  
Christopher Camp ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Range Of Motion ◽  
External Rotation ◽  
Significant Risk ◽  
Case Series ◽  
Significant Risk Factor ◽  
Professional Baseball ◽  
Level Of Evidence ◽  
Baseball Players ◽  
Shoulder Flexion

Background: Loss of upper and lower extremity range of motion (ROM) is a significant risk factor for injuries in professional baseball players. Purpose/Hypothesis: The purpose was to determine changes in ROM in professional baseball players over the course of a single season and their careers. We hypothesized that pitchers and position players would lose ROM, specifically total shoulder motion (total ROM [TROM]) and hip internal rotation (IR), over the course of a season and their careers. Study Design: Case series; Level of evidence, 4. Methods: Upper and lower extremity ROM measurements were recorded during pre-, mid-, and postseason on all professional baseball players for a single organization between 2011 and 2018. ROM measurements were compared for pitchers and position players over the course of the season and their careers. Also, ROM measurements over the pre-, mid-, and postseason were compared between pitchers and position players. Results: A total of 166 professional baseball players (98 pitchers, 68 position players) were included. Pitcher hip external rotation (ER; P < .001), IR ( P = .010), and TROM ( P < .001) for lead and trail legs decreased over the course of the season. Pitcher shoulder ER ( P = .005), TROM ( P = .042), and horizontal adduction ( P < .001) significantly increased over the course of the season. Position player shoulder flexion ( P = .046), hip ER ( P < .001, lead leg; P < .001, trail leg), and hip TROM ( P = .001; P = .002) decreased over the course of the season. Position player shoulder ER ( P = .031) and humeral adduction ( P < .001) significantly increased over the course of the season. Over the course of pitchers’ careers, there was decreased shoulder IR ( P = .014), increased shoulder horizontal adduction ( P < .001), and hip IR ( P = .042) and hip TROM ( P = .027) for the lead leg. Position players experienced loss of hip TROM ( P = .010, lead leg; P = .018, trail leg) over the course of their careers. Pitchers started with and maintained more shoulder ER and gained more shoulder TROM over a season as compared with position players. Conclusion: Pitchers and position players saw overall decreases in hip ROM but increases in shoulder ROM over the course of the season and career.

Late Rearfoot Eversion and Lower-limb Internal Rotation Caused by Changes in the Interaction between Forefoot and Support Surface

2009 ◽  
Vol 99 (6) ◽  
pp. 503-511 ◽  
Author(s):  
Thales R. Souza ◽  
Rafael Z. Pinto ◽  
Renato G. Trede ◽  
Renata N. Kirkwood ◽  
Antônio E. Pertence ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Internal Rotation ◽  
Lower Limb ◽  
Repeated Measures ◽  
Three Dimensional ◽  
Support Surface ◽  
Kinetic Chain ◽  
Mechanical Factors ◽  
Lateral Wedges ◽  
Rearfoot Eversion

Background: The influence of distal mechanical factors that change the interaction between the forefoot and the support surface on lower-limb kinematics is not well established. This study investigated the effects of the use of lateral wedges under the forefoot on the kinematics of the lower extremity during the stance phase of walking. Methods: Sixteen healthy young adults participated in this repeated-measures study. They walked wearing flat sandals and laterally wedged sandals, which were medially inclined only in the forefoot. One wedged sandal had a forefoot lateral wedge of 5° and the other wedged sandal had a forefoot lateral wedge of 10°. Kinematic variables of the lower extremity, theoretically considered clinically relevant for injury development, were measured with a three-dimensional motion analysis system. The variables were evaluated for three subphases of stance: loading response, midstance, and late stance. Results: The 5° laterally wedged sandal increased rearfoot eversion during midstance and the 10° laterally wedged sandal increased rearfoot eversion during mid- and late stances, in comparison to the use of flat sandals. The 10° laterally wedged sandal produced greater internal rotation of the shank relative to the pelvis and of the hip joint, during the midstance, also compared to the use of flat sandals. Conclusions: Lateral wedges under the forefoot increase rearfoot eversion during mid-and late stances and may cause proximal kinematic changes throughout the lower-extremity kinetic chain. Distal mechanical factors should be clinically addressed when a patient presents late excessive rearfoot eversion during walking. (J Am Podiatr Med Assoc 99(6): 503–511, 2009)

Relationships between Knee Valgus, Hip-Muscle Strength, and Hip-Muscle Recruitment during a Single-Limb Step-Down

2009 ◽  
Vol 18 (1) ◽  
pp. 104-117 ◽  
Author(s):  
John H. Hollman ◽  
Barbara E. Ginos ◽  
Jakub Kozuchowski ◽  
Amanda S. Vaughn ◽  
David A. Krause ◽  
...  
Keyword(s):  
Muscle Strength ◽  
External Rotation ◽  
Frontal Plane ◽  
Gluteus Maximus ◽  
Knee Valgus ◽  
Outcome Measurements ◽  
Hip Muscle ◽  
Hip Abduction ◽  
Step Down ◽  
Rotation Strength

Context:Reduced strength and activation of hip muscles might correlate with increased weight-bearing knee valgus.Objective:To describe relationships among frontal-plane hip and knee angles, hip-muscle strength, and electromyographic (EMG) recruitment in women during a step-down.Design:Exploratory study.Setting:Laboratory.Participants:20 healthy women 20 to 30 years of age.Interventions:Frontal-plane hip and knee angles were measured. Gluteus maximus and medius recruitment were examined with surface EMG. Hip-abduction and -external-rotation strength were quantified with handheld dynamometry.Main Outcome Measurements:The authors analyzed correlation coefficients between knee and hip angles, gluteus maximus and medius EMG, and hip-abduction and -external-rotation strength.Results:Hip-adduction angles (r = .755, P = .001), gluteus maximus EMG (r = −.451, P = .026), and hip-abduction strength (r = .455, P = .022) correlated with frontal-plane projections of knee valgus.Conclusions:Gluteus maximus recruitment might have greater association with reduced knee valgus in women than does external-rotation strength during step-down tasks. Gluteus medius strength might be associated with increased knee valgus.

A Medical Device for Patellofemoral Disorders: Design and Development

2015 ◽  
Author(s):  
Ana Leal ◽  
Rogério Pereira ◽  
Hélder Pereira ◽  
João Paulo Flores Fernandes ◽  
Filipe Silva ◽  
...  
Keyword(s):  
Medical Device ◽  
Patellofemoral Joint ◽  
External Rotation ◽  
Clinical History ◽  
Clinical Tests ◽  
Human Knee ◽  
Full Characterization ◽  
Early Results ◽  
Joint Motions

Patellofemoral disorders have been recognized as one of the major causes of the human knee articulation problems. In general, the current available methods to assess patellofemoral joint disorders include the analysis of clinical history, clinical tests and imaging exams. These approaches are ambiguous in the diagnosis produced since they strongly depend on the expertise of the examinant. With the purpose to assist in the diagnosis process of the patellofemoral disorders, a new medical device is proposed throughout this work. In the sequel of this process, the identification and full characterization of the main issues associated with patellofemoral joint are presented. The main features and the engineered solution are accuracy and reproducibility, possibility of incorporation into imaging equipment, adaptability to a large range of knee sizes, easy and cheap to manufacture and anatomically and ergonomically fashion. The mechanical system designed and built allows for the measurement and quantification of the most significant patellofemoral joint motions, more precisely the medial-lateral translation, internal-external tilt and internal-external rotation. The validation of the medical device is investigated here by analyzing the data produced from actual clinical exams, being the early results quite satisfactory and very promising for extensive use in helping in the diagnosis of the patellofemoral disorders.

Associations Between Functional and Isolated Performance Measures in College Women’s Soccer Players

2017 ◽  
Vol 26 (5) ◽  
pp. 376-385 ◽  
Author(s):  
Ryan S. McCann ◽  
Kyle B. Kosik ◽  
Masafumi Terada ◽  
Megan Q. Beard ◽  
Gretchen E. Buskirk ◽  
...  
Keyword(s):  
Data Collection ◽  
Lower Extremity ◽  
Athletic Training ◽  
Performance Measures ◽  
Functional Performance ◽  
External Rotation ◽  
Soccer Players ◽  
Hip Strength ◽  
Data Collection And Analysis ◽  
Women's Soccer

Context:The Star Excursion Balance Test (SEBT) and Functional Movement Screen (FMS) are functional performance measures capable of predicting lower-extremity injury risk. While suboptimal SEBT and FMS performances are influenced by multiple factors, the contribution of hip strength and flexibility to these tests is mostly unknown. Examination of hip strength and flexibility influences on the SEBT and FMS may direct clinicians to better methods of correcting functional deficits.Objective:Determine the relationships of isometric hip strength and hip passive range of motion (PROM) with functional performance measures.Design:Cross-sectional.Setting:Athletic training facility.Participants:43 NCAA Division I women’s soccer players (19.65 ± 1.12 y; 166.93 ± 3.84 cm; 60.99 ± 4.31 kg) volunteered.Data Collection and Analysis:All participants were tested bilaterally in the SEBT; the deep squat, in-line lunge, hurdle step, and straight leg raise, comprising a lower-extremity FMS (FMS-LE); hip internal and external rotation PROM; and isometric hip extension strength (HEXT). The mean of the 3 averaged, normalized SEBT scores was used as a composite score. Pearson product moment correlations assessed relationships of SEBT and FMS-LE scores with PROM and HEXT. Significance was set a priori at P < .05.Results:Pearson correlations revealed anterior (ANT) SEBT scores had a low negative association with HEXT (r = –0.33,P = .004) and a low positive association with hip internal rotation PROM (PROM-IR) (r = .43,P = .003). All other correlations were negligible.Conclusions:Flexibility training aimed at PROM-IR may contribute to improved ANT scores. Targeting HEXT and hip external rotation PROM are likely not preferred means of correcting deficits in SEBT and FMS-LE performance.

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