Prevalence of lower limb deformities among primary school students

Background Lower limb deformities could affect child's quality of life and may worsen with time. This work aims to study the prevalence of lower limb deformities among primary school students in our governorate. Methods This cross-sectional descriptive study was carried out on 4689 students attending 12 public primary schools during the academic year 2019–2020.Complete clinical examination was done for picking of cases of genu varum, genu valgum, genu recurvatum, flat foot, pes cavus, hallux valgus, in-toeing, and lower limb discrepancy, and x-ray on both feet, pelvis, and full-length lower limb was requested. Results This cross-sectional descriptive study included 4689 students. The prevalence of lower limb (LL) deformities was 16.61%. One hundred twenty-three (2.62%) children had a positive history of musculoskeletal pain, 0.09% had genu varum, 0.11% had genu valgum, 0.75% had Genu recurvatum, 0.03% had LL discrepancy, 13.86% had flexible flat foot, 1.22% had rigid flat foot, 0.23% had pes cavus, 1.04 % had in-toeing, 0.06% had hallux varus, and 0.11% had hallux valgus. Conclusions Lower limb deformities are a considerable problem in primary school students that need early diagnosis because it could affect child’s future, health, and career. Further studies are needed to investigate spinal deformity, vit D level, calcium level, foot wear, and school bag weight as hidden factors.

Comparison of anterior knee laxity, stiffness, genu recurvatum, and general joint laxity in the late follicular phase and the ovulatory phase of the menstrual cycle

Background One risk factor for anterior cruciate ligament (ACL) injury may be fluctuations in female hormones. This study examined variability in joint laxity, as a risk factor for ACL injury, during the menstrual cycle. Methods Subjects were 15 female university students with regular menstrual cycles. We measured estradiol (E2) concentration, anterior knee laxity (AKL), stiffness, genu recurvatum (GR), and general joint laxity (GJL) during the late follicular and ovulatory phases. AKL was measured as anterior tibial displacement of the femur after application of 44-, 89-, and 133-N loads on the tibia. Stiffness was calculated as Δforce/Δdisplacement at loads of 44–89 N and between 89 and 133 N. GR was measured prone, with the base of the patella distal to the edge of the bed. The University of Tokyo joint laxity test was used to evaluate GJL. Results E2 concentration was significantly higher in the ovulatory phase than in the late follicular phase (p = 0.018), AKL and stiffness did not differ significantly between phases, and GR and GJL were significantly higher in the ovulatory phase than in the late follicular phase (p = 0.011, 0.031). Conclusion These findings suggest that E2 concentrations may affect GR and GJL during the menstrual cycle.

Change of Knee Cartilage Components in Stroke Patients with Genu Recurvatum Analyzed by Zero TE MR Imaging

-BACKGROUND: Genu recurvatum in stroke patient hemiplegia causes readily cumulative damage and degenerative changes of knee cartilage. It is important to detect early lesions of cartilage for appropriate treatment and rehabilitation.-PURPOSE: The purpose is to provide theoretical basis for early rehabilitation of hemiplegia patients. -STUDY TYPE: Cross-sectional study. -POPULATION: 39 Stroke patients with genu recurvatum and 9 healthy volunteers. -SEQUENCE: We used zero TE double echo imaging sequence. -ASSESSMENT: Analyze the water content in knee joint cartilage at 12 different sites of stroke patients with genu recurvatum using a method similar to porosity index. -STATISTICAL TESTS: Statistical analysis was performed using SPSS 17.0 statistical software. The mean ± standard deviation was used to represent the mean. The independent sample t test was used for all mean comparisons. When the data did not conform to the normal distribution or variance heterogeneity, the non-parametric test was used. P< 0.05 was considered statistically significant.-RESULTS: When compared hemiplegia limb vs. non-hemiplegia limb in patients, the ratio of deep/shallow free water content of the cartilages at the junction of the femur and anterior horn (1.16 vs. 1.06) and posterior horn (1.13 vs. 1.25) of lateral meniscus were significant differences (P<0.05). -DATA CONCLUSION: Conclusion is that Genu recurvatum in stroke patients with hemiplegia can cause changes in moisture content of knee cartilage, and the changes of knee cartilage are more obvious with the increase of genu recurvatum. The so-called "healthy limb" is no longer the real meaning of healthy limb, and should be considered simultaneously with the affected limb in the development of rehabilitation treatment plan.

Effect of Pulley Therapy on Genurecurvatum in Children with Unilateral Cerebral Palsy: Randomized Controlled Trial

Objectives: Genu recurvatum commonly represents a more challenging problem that interferes with activities of daily living in children with cerebral palsy. This study aimed to investigate the effect of pulley therapy on genu recurvatum in children with unilateral cerebral palsy. Methods: Forty children with unilateral cerebral palsy aged from 3 to 6 years were randomly allocated into two equal groups: control group and study group. Both groups received designed physical therapy program in addition, study group received pulley therapy program instead of using free weights in control group for strengthening hamstring and tibialis anterior muscles. The program's protocol applied for one hour, three times per week for three successive months for each group. Degree of genu recurvatum was assessed pre- and post-treatment by using digital goniometer while, muscle strength of hamstring and tibialis anterior was assessed by using Lafayette manual muscle tester device. Results: Both groups showed significant improvement of all measured variables post treatment. The significant improvement after treatment in degree of genu recurvatum and muscle strength was obtained in favor to study group (p<0.05). Conclusions: Pulley therapy may be used within the rehabilitation program of children with unilateral cerebral palsy to treat genu recurvatum. Key words: Unilateral cerebral palsy, Hemiplegia, Genu recurvatum, Progressive resistance training, Pulley therapy.

Effect of Pulley Therapy on Genurecurvatum in Children with Unilateral Cerebral Palsy: Randomized Controlled Trial

Objectives: Genu recurvatum commonly represents a more challenging problem that interferes with activities of daily living in children with cerebral palsy. This study aimed to investigate the effect of pulley therapy on genu recurvatum in children with unilateral cerebral palsy. Methods: Forty children with unilateral cerebral palsy aged from 3 to 6 years were randomly allocated into two equal groups: control group and study group. Both groups received designed physical therapy program in addition, study group received pulley therapy program instead of using free weights in control group for strengthening hamstring and tibialis anterior muscles. The program's protocol applied for one hour, three times per week for three successive months for each group. Degree of genu recurvatum was assessed pre- and post-treatment by using digital goniometer while, muscle strength of hamstring and tibialis anterior was assessed by using Lafayette manual muscle tester device. Results: Both groups showed significant improvement of all measured variables post treatment. The significant improvement after treatment in degree of genu recurvatum and muscle strength was obtained in favor to study group (p<0.05). Conclusions: Pulley therapy may be used within the rehabilitation program of children with unilateral cerebral palsy to treat genu recurvatum. Key words: Unilateral cerebral palsy, Hemiplegia, Genu recurvatum, Progressive resistance training, Pulley therapy.