scholarly journals Identifying Relationships Among Lower Extremity Alignment Characteristics

2009 ◽  
Vol 44 (5) ◽  
pp. 511-518 ◽  
Author(s):  
Anh-Dung Nguyen ◽  
Sandra J. Shultz
Keyword(s):  
Lower Extremity ◽  
Injury Risk ◽  
Femoral Anteversion ◽  
Tibial Torsion ◽  
Tibiofemoral Angle ◽  
Navicular Drop ◽  
Lower Extremity Alignment ◽  
Select Group ◽  
Genu Recurvatum ◽  
The Relationship

Abstract Context: The relationship between lower extremity alignment and lower extremity injury risk remains poorly understood, perhaps because most authors have examined only individual or a select group of alignment variables. Examining the relationships among alignment variables may allow us to more accurately describe lower extremity posture and clarify the relationship between lower extremity alignment and injury risk in future studies. Objective: To measure lower extremity alignment variables and examine whether relationships could be identified among these variables. Design: Observational study. Setting: Laboratory. Patients or Other Participants: Two hundred eighteen (102 males: age  =  23.1 ± 3.2 years, height  =  177.3 ± 8.4 cm, mass  =  80.8 ± 13.0 kg; 116 females: age  =  21.8 ± 2.7 years, height  =  163.5 ± 7.4 cm, mass  =  63.4 ± 12.4 kg) healthy, college-aged participants. Main Outcome Measure(s): We measured pelvic angle, femoral anteversion, quadriceps angle, tibiofemoral angle, genu recurvatum, and tibial torsion to the nearest degree and navicular drop to the nearest millimeter on the right and left lower extremities. Separate principal components factor analyses were performed for each sex and side (left, right). Results: A distinct lower extremity factor was identified, with relationships observed among increased pelvic angle, increased quadriceps angle, and increased tibiofemoral angle. A second distinct lower extremity factor was identified, with relationships observed among increased supine genu recurvatum, decreased tibial torsion, and increased navicular drop. Femoral anteversion loaded as an independent third factor. These distinct lower extremity alignment factors were consistent across side and sex. Conclusions: Factor analysis identified 3 distinct lower extremity alignment factors that describe the potential interactions among lower extremity alignment variables. Future authors should examine how these collective alignment variables, both independently and in combination, influence dynamic knee function and risk for lower extremity injuries.

scholarly journals The Relationship Between Lower Extremity Alignment Characteristics and Anterior Knee Joint Laxity

2009 ◽  
Vol 1 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Sandra J. Shultz ◽  
Anh-Dung Nguyen ◽  
Beverly J. Levine
Keyword(s):  
Lower Extremity ◽  
Pelvic Tilt ◽  
Knee Laxity ◽  
Tibiofemoral Angle ◽  
Navicular Drop ◽  
Lower Extremity Alignment ◽  
Anterior Knee Laxity ◽  
Genu Recurvatum ◽  
Anterior Pelvic Tilt ◽  
Anterior Knee

Background: Lower extremity alignment may influence the load distribution at the knee, potentially predisposing the anterior cruciate ligament to greater stress. We examined whether lower extremity alignment predicted the magnitude of anterior knee laxity in men and women. Hypothesis: Greater anterior pelvic angle, hip anteversion, tibiofemoral angle, genu recurvatum, and navicular drop will predict greater anterior knee laxity. Study Design: Descriptive laboratory study. Methods: Women (n = 122) and men (n = 97) were measured for anterior knee laxity and 7 lower extremity alignment variables on their dominant stance leg. Linear regression determined the extent to which the alignment variables predicted anterior knee laxity for each sex. Results: Lower anterior pelvic tilt and tibiofemoral angle, and greater genu recurvatum and navicular drop were related to greater anterior knee laxity in women, explaining 28.1% of the variance ( P < .001). Lower anterior pelvic tilt and greater hip anteversion, genu recurvatum and navicular drop were predictors of greater anterior knee laxity in men, explaining 26.5% of the variance ( P < .001). Conclusion: Lower anterior pelvic tilt, greater knee hyperextension, and foot pronation predicted greater anterior knee laxity in both men and women, with genu recurvatum and navicular drop having the greatest impact on anterior knee laxity. Greater hip anteversion was also a strong predictor in men, while a lower tibiofemoral angle was a significant predictor in women. Clinical Relevance: The associations between lower extremity alignment and anterior knee laxity suggest that alignment of the hip, knee, and ankle may be linked to or contribute to abnormal loading patterns at the knee, potentially stressing the capsuloligamentous structures and promoting greater joint laxity.

scholarly journals Sex Differences and Representative Values for 6 Lower Extremity Alignment Measures

2009 ◽  
Vol 44 (3) ◽  
pp. 249-255 ◽  
Author(s):  
Jennifer M. Medina McKeon ◽  
Jay Hertel
Keyword(s):  
Lower Extremity ◽  
Pelvic Tilt ◽  
Cruciate Ligament ◽  
Femoral Anteversion ◽  
Injury Rates ◽  
Men And Women ◽  
Lower Extremity Alignment ◽  
Genu Recurvatum ◽  
Anterior Pelvic Tilt ◽  
Anterior Cruciate

Abstract Context: A discrepancy in anterior cruciate ligament (ACL) injury rates exists between men and women. Structural differences between the sexes often are implicated as a factor in this discrepancy. Researchers anecdotally assume that men and women tend to display different normative values for certain lower extremity alignments, but published information about these values is limited. Objective: To evaluate the effect of sex on 6 measures of lower extremity alignment and to report representative values of these measures from a sample of active adults and elite athletes. Design: Descriptive cohort design. Setting: University research laboratory. Patients or Other Participants: A total of 118 healthy adults (57 men: age  =  21.1 ± 3.0 years, height  =  179.1 ± 7.3 cm, mass  =  79.8 ± 13.0 kg; 61 women: age  =  20.0 ± 1.6 years, height  =  167.7 ± 6.7 cm, mass  =  62.7 ± 5.5 kg) volunteered. Main Outcome Measure(s): Six common measures of lower extremity posture (navicular drop, tibial varum, quadriceps angle, genu recurvatum, anterior pelvic tilt, femoral anteversion) were collected using established methods. One measurement was taken for each participant for each lower extremity alignment. We measured the right lower extremity only. Results: Compared with men, women demonstrated larger quadriceps angles, more genu recurvatum, greater anterior pelvic tilt, and more femoral anteversion. Conclusions: We observed differences between men and women for 4 of the 6 lower extremity alignments that we measured. Future researchers should focus on identifying how sex and skeletal alignment affect biomechanical performance of functional tasks and what these differences specifically mean regarding the discrepancy in anterior cruciate ligament injury rates between the sexes.

scholarly journals A Preliminary Multifactorial Approach Describing the Relationships Among Lower Extremity Alignment, Hip Muscle Activation, and Lower Extremity Joint Excursion

2011 ◽  
Vol 46 (3) ◽  
pp. 246-256 ◽  
Author(s):  
Anh-Dung Nguyen ◽  
Sandra J. Shultz ◽  
Randy J. Schmitz ◽  
Richard M. Luecht ◽  
David H. Perrin
Keyword(s):  
Lower Extremity ◽  
Muscle Activation ◽  
Gluteus Maximus ◽  
Gluteus Medius ◽  
Femoral Anteversion ◽  
Navicular Drop ◽  
Hip Muscle ◽  
Single Leg Squat ◽  
Multifactorial Approach ◽  
Hip Internal Rotation

Context: Multiple factors have been suggested to increase the risk of faulty dynamic alignments that predict noncontact anterior cruciate ligament injury. Few researchers have examined this relationship using an integrated, multifactorial approach. Objective: To describe the relationship among static lower extremity alignment (LEA), hip muscle activation, and hip and knee motion during a single-leg squat. Design: Descriptive laboratory study. Setting: Research laboratory. Patients or Other Participants: Thirty men (age = 23.9 ± 3.6 years, height = 178.5 ± 9.9 cm, mass = 82.0 ± 14.1 kg) and 30 women (age = 22.2 ± 2.6 years, height = 162.4 ± 6.3 cm, mass = 60.3 ± 8.1 kg). Main Outcome Measure(s): Pelvic angle, femoral anteversion, quadriceps angle, tibiofemoral angle, and genu recurvatum were measured to the nearest degree; navicular drop was measured to the nearest millimeter. The average root mean square amplitude of the gluteus medius and maximus muscles was assessed during the single-leg squat and normalized to the peak root mean square value during maximal contractions for each muscle. Kinematic data of hip and knee were also assessed during the single-leg squat. Structural equation modeling was used to describe the relationships among static LEA, hip muscle activation, and joint kinematics, while also accounting for an individual's sex and hip strength. Results: Smaller pelvic angle and greater femoral anteversion, tibiofemoral angle, and navicular drop predicted greater hip internal-rotation excursion and knee external-rotation excursion. Decreased gluteus maximus activation predicted greater hip internal-rotation excursion but decreased knee valgus excursion. No LEA characteristic predicted gluteus medius or gluteus maximus muscle activation during the single-leg squat. Conclusions: Static LEA, characterized by a more internally rotated hip and valgus knee alignment and less gluteus maximus activation, was related to commonly observed components of functional valgus collapse during the single-leg squat. This exploratory analysis suggests that LEA does not influence hip muscle activation in controlling joint motion during a single-leg squat.

scholarly journals The Relationship Between Lower Extremity Alignment and Low Back, Hip, and Foot Pain During Pregnancy

2016 ◽  
Vol 40 (3) ◽  
pp. 139-146
Author(s):  
Kathryn D. Harrison ◽  
Corrie Mancinelli ◽  
Krystal Thomas ◽  
Petronela Meszaros ◽  
Jean L. McCrory
Keyword(s):  
Lower Extremity ◽  
Low Back ◽  
Foot Pain ◽  
Lower Extremity Alignment ◽  
The Relationship

scholarly journals The Relationship Among Foot Posture, Core and Lower Extremity Muscle Function, and Postural Stability

2014 ◽  
Vol 49 (2) ◽  
pp. 173-180 ◽  
Author(s):  
Stephen C. Cobb ◽  
David M. Bazett-Jones ◽  
Mukta N. Joshi ◽  
Jennifer E. Earl-Boehm ◽  
C. Roger James
Keyword(s):  
Lower Extremity ◽  
Injury Risk ◽  
Arch Height ◽  
Ankle Inversion ◽  
Foot Structure ◽  
Lower Extremity Muscle ◽  
Foot Posture ◽  
Ankle Strength ◽  
Inversion Strength ◽  
The Relationship

Context: Identification of impaired balance as a risk factor for lower extremity injury regardless of injury history has led to subsequent investigation of variables that may adversely affect balance in healthy individuals. Objectives: To investigate the relationship among core and lower extremity muscle function, foot posture, and balance. Design: Descriptive laboratory study. Setting: Musculoskeletal injury biomechanics laboratory. Patients or Other Participants: A total of 108 individuals (40 men, 68 women; age = 22.8 ± 4.7 years, height = 168.5 ± 10.4 cm, mass = 69.9 ± 13.3 kg) participated in the study. Main Outcome Measure(s): Core endurance was assessed during 1 time-to-failure trial, and isometric hip and ankle strength were assessed using a handheld dynamometer and isokinetic dynamometer, respectively. Foot structure was quantified using the digital photographic measurement method. Single-limb–stance time to boundary was assessed using a force plate during an eyes-closed condition. Hierarchical multiple regression analyses were performed to predict balance using lower extremity strength, foot posture, and core endurance. Results: Foot posture (β = −0.22, P = .03) and ankle-inversion strength (β = −0.29, P = .006) predicted mediolateral balance. Increasing arch posture and ankle-inversion strength were associated with decreased mediolateral single-limb–stance balance. Conclusions: Increasing arch height was associated with decreased mediolateral control of single-limb stance. The relationship between time to boundary and injury risk, however, has not been explored. Therefore, the relationship between increasing arch height and injury due to postural instability cannot be determined from this study. If authors of future prospective studies identify a relationship between decreased time to boundary and increased injury risk, foot structure may be an important variable to assess during preparticipation physical examinations. The relationship between increasing ankle-inversion strength and decreased balance may require additional study to further elucidate the relationship between ankle strength and balance.

scholarly journals Static Balance in Patients With Patellofemoral Pain Syndrome

2011 ◽  
Vol 3 (6) ◽  
pp. 524-527 ◽  
Author(s):  
Seyit Citaker ◽  
Defne Kaya ◽  
Inci Yuksel ◽  
Baran Yosmaoglu ◽  
John Nyland ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Case Series ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Lower Extremity Alignment ◽  
Q Angle ◽  
Prospective Case Series ◽  
The Relationship ◽  
Symptomatic Side

Background: The relationship between one-leg static standing balance (OLSSB) and patellofemoral pain syndrome (PFPS) is unknown. Hypothesis: OLSSB decreases in patients with PFPS. Design: Prospective case series. Methods: Fifty-two women with unilateral PFPS were enrolled in this study. OLSSB was evaluated with a stabilometer. Q angle was measured with a lengthened-arm universal goniometer. Lower extremity alignment was analyzed with full-length standing anteroposterior teleroentgenograms. Quadriceps and hamstring strength was measured on an isokinetic dynamometer. Results: There were significant differences in OLSSB, Q angle, and strength of quadriceps and hamstring between the symptomatic and asymptomatic sides. There was a correlation between the strength of the quadriceps and hamstring and OLSSB, while there was no correlation between OLSSB and the severity of pain, lower extremity alignment, and Q angle on the symptomatic side. Conclusions: OLSSB and quadriceps and hamstring strength decreased and Q angle increased on the symptomatic side in PFPS patients. A relationship between OLSSB and pain, Q angle, and lower extremity alignment was not detected, while there was a correlation between the strength of the quadriceps and hamstring and OLSSB. Clinical Relevance: A quadriceps and hamstring strengthening may be beneficial to improve OLSSB in patients with PFPS.

scholarly journals Comparison of multiple flatfoot indicators in 5–8-year-old children

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 246-256
Author(s):  
Saidas Žukauskas ◽  
Vidmantas Barauskas ◽  
Emilis Čekanauskas
Keyword(s):  
Indirect Method ◽  
Femoral Anteversion ◽  
Factors Associated ◽  
Navicular Drop ◽  
Metatarsal Angle ◽  
Age Dependent ◽  
Foot Posture ◽  
Radiological Measurements ◽  
Foot Position ◽  
The Relationship

Abstract Background The foot posture is age dependent. The purpose of this study was to investigate the relationship between the 6-item version of the foot posture index (FPI) and other clinical, foot anthropometric, radiological measurements for the foot position in 5–8-year-old children. Methods A total of 301 participants with a mean age of 6.4  ±  1.14 years were enrolled in the study. Children were examined physically, clinically, and radiologically to measure the FPI and navicular drop (ND) test, resting calcaneal stance position (RCSP) angle, Chippaux–Smirak index (CSI), Staheli index (SI), calcaneal pitch (CP) angle, talocalcaneal angle (TCA), and the first lateral metatarsal angle. Tibial torsions, internal rotation of the hip as an indirect method of femoral anteversion, and Beighton scale were analyzed for factors associated with flatfoot prevalence. Results The study included children with normal and flexible flatfeet. Statistical analysis showed a significant FPI score correlation with other parameters (SI, CSI, RCSP, ND, CP, TMA, and TCA showed strong and moderate correlations, p < 0.001). Overall, the strongest associates are CSI (β = 0.34) and ND (β = 0.28). Other indicators have relatively small relationships with the FPI. Conclusion A positive correlation was observed between FPI-6 and ND test, CSI in 5–8-year-old children. All three prominent foot posture indicators (FPI-6, ND, and CSI) might be used as a primary or preferred tool in clinical practice.

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