Is Hip Muscle Strength Associated with Dynamic Knee Valgus in a Healthy Adult Population? A Systematic Review.
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SUBMITTER: Alzahrani AM
PROVIDER: S-EPMC8304771 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundA range of non-contact injuries such as anterior cruciate ligament tear, and patellofemoral pain syndrome are caused by disordered knee joint loading from excessive dynamic knee valgus (DKV). Previous systematic reviews showed that DKV could be modified through the influence of hip strength and ankle range of motion. Therefore, the purpose of this systematic review was to examine the effects of exercise intervention which involved either top-down or bottom-up kinetic chains on minimizing DKV in male and female adults and adolescents, with and without existing knee pain.MethodologyElectronic searches were conducted in SAGE, Science Direct, SCOPUS, and Pubmed. The search strategy consisted of medical subject headings and free-text search keywords, synonyms and variations of 'exercise intervention,' 'knee alignment,' 'dynamic knee valgus', 'knee abduction' that were merged via the Boolean operator 'AND' and 'OR'. The search was conducted on full-text journals that documented the impact of the exercise intervention program involving either the bottom-up or top-down DKV mechanism on the knee kinematics. Furthermore, exercise intervention in this review should last at least one week which included two or three sessions per week. This review also considered both men and women of all ages with a healthy or symptomatic knee problem. The risk of bias of the included studies was assessed by Cochrane risk assessment tool. The protocol of this review was registered at PROSPERO (registration number: CRD42021219121).ResultsTen studies with a total of 423 participants (male = 22.7%, female = 77.3%; adults = 249, adolescents = 123; pre-adolescent = 51) met the inclusion criteria of this review. Seven studies showed the significant effects of the exercise intervention program (range from two weeks to ten weeks) on reducing DKV. The exercise training in these seven studies focused on muscle groups directly attached to the knee joint such as hamstrings and gastrocnemius. The remaining three studies did not show significant improvement in DKV after the exercise intervention (range between eight weeks to twelve weeks) probably because they focused on trunk and back muscles instead of muscles crossing the knee joint.ConclusionExercises targeting specific knee-joint muscles, either from top-down or bottom-up kinetic chain, are likely to reduce DKV formation. These results may assist athletes and coaches to develop effective exercise program that could minimize DKV and ultimately prevent lower limb injuries.
| S-EPMC8265381 | biostudies-literature
Project description:Background and purposePostoperative muscle strength and component alignment are important factors affecting functional results after total knee arthroplasty (TKA). We are not aware of any studies that have investigated the relationship between them. We therefore investigated whether coronal malalignment of the mechanical axis and/or of individual implant components would affect knee muscle strength and function 1 year after TKA surgery.Patients and methodsWe included 120 consecutive osteoarthritis (OA) patients admitted for TKA. Preoperative active range of motion (ROM) of the knee, patient age, sex, and BMI were recorded and the Knee Society score (KSS) and knee joint extensor/flexor muscle strength were assessed. At 1-year follow-up, the mechanical and coronal component alignment was measured from a postoperative long standing radiograph, and ROM, KSS, and muscle strength measurements were taken in 91 patients. Functional outcome and muscle strength measurements were compared between normally aligned and malaligned TKA groups.Results29 of 91 TKAs were malaligned, i.e. they deviated more than 3° from the neutral mechanical axis. 18 femoral components and 15 tibial components were malaligned. Before surgery, the malaligned and normally aligned groups were similar regarding sex distribution, BMI, ROM, KSS, and muscle strength. At the 1-year follow-up, the differences between the groups regarding knee joint function and muscle strength were small, not statistically significant, and barely clinically relevant.InterpretationModerate varus/valgus malalignment of the mechanical axis or of individual components has no relevant clinical effect on function or muscle strength 1 year after TKA surgery.
| S-EPMC4750774 | biostudies-literature
Project description:IntroductionReduced hip abductor strength may indirectly lead to changes in knee kinematics and functional impairment and has been reported in patients with patellofemoral pain and knee osteoarthritis (OA). Limited information is available regarding hip abductor strength following total or unicompartmental knee arthroplasty (TKA/UKA). The aims of this systematic review are to synthesise the evidence of hip abductor muscle strength deficits in patients following TKA/UKA and to determine influencing factors for these deficits.Methods and analysisEmbase, Medline, SportDiscus, the Web of Science Core Collection and Scopus will be searched for human-based clinical studies investigating hip abductor muscle strength after TKA/UKA for knee OA or avascular necrosis (AVN). Articles studying hip abductor strength after knee arthroplasty for post-traumatic OA will not be considered. No restriction on study design, prosthesis design, surgical approach, patient characteristics or severity of OA/AVN will be applied. We will search articles published between 1 January 1990 and the date of our last search. Only articles in English or German language will be considered for inclusion. Studies reporting manually measured muscle strength or measurements performed at hip abduction angles other than 0° will be excluded. References will be screened by two reviewers independently. Where necessary, a third author will make the final decision. The assessment of quality and risk of bias will be performed with the modified Newcastle-Ottawa scale. Data will be extracted and presented in a tabular form. Depending on availability, comparable subgroup and meta-analyses will be conducted. Patient characteristics such as age, sex and surgical approach or rehabilitation programme will be analysed, if sufficient data are available.Ethics and disseminationNo ethics approval is required. The results will be published in a peer-reviewed journal and as conference presentation.
| S-EPMC7430403 | biostudies-literature
Project description:The dynamic knee valgus (DKV) during different sport maneuvers has been widely described as risk factor to develop an anterior cruciate ligament injury. Hip and knee muscles seem to have a crucial role to prevent the dynamic knee valgus. This study aimed to give normative and correlational data about DKV and hip and knee neuromuscular response (NMR) among healthy active males. The hypothesis is that DKV could be correlated with hip NMR. A cross-sectional correlational study. Research Anatomy Laboratory. The study was carried out among 50 active, non-injured males. Dynamic Knee-Valgus angle and lower limb posterior chain muscles Neuromuscular Response. DKV was measured using Kinovea software during a Single-Legged Drop Jump test and NMR was measured using tensiomyography and myotonometry for gluteus maximum, biceps femoris, semitendinosus, lateral and medial gastrocnemius. Right and left limbs were both performed and analyzed independently. No significant correlation was observed between DKV and hip and knee muscles NMR. This study shows normative and correlational data about dynamic knee valgus, tensiomyography and myotonometry for healthy and active males. The DKV control seems to be non-correlated with isolated hip and knee muscles NMR so this suggests it is more about Central Nervous System activity than about isolated muscles NMR.
| S-EPMC7710730 | biostudies-literature
Project description:BackgroundDynamic knee valgus (DKV) is an abnormal movement pattern visually characterized by excessive medial movement of the lower extremity during weight bearing. Differences in hip and knee kinematic components of DKV may explain the emergence of different pain problems in people who exhibit the same observed movement impairment. Using a secondary analysis of exiting data sets, we sought to determine whether hip and knee frontal and transverse plane angles during a functional task differed between women with patellofemoral pain and women with chronic hip joint pain, and the relationship between joint-specific kinematics and pain in these 2 pain populations.MethodsIn the original studies, 3-dimensional hip and knee kinematics during a single leg squat were obtained in 20 women with patellofemoral pain and 14 women with chronic hip joint pain who demonstrated visually classified DKV. Pain intensity during the squat was assessed in both groups. For the secondary analysis, kinematic data were compared between pain groups using their respective control groups as a reference. Within each pain group, correlation coefficients were used to determine the relationship between kinematics and pain during the squat.ResultsHip adduction and contralateral pelvic drop were greater in those with chronic hip joint pain compared to those with patellofemoral pain (effect sizes ≥ 0.40). Greater knee external rotation (r=0.47, p=0.04) was correlated with greater knee pain in those with patellofemoral pain, while greater hip adduction (r =0.53, p =0.05) and greater hip internal rotation (r =0.55, p =0.04) were correlated with greater hip pain in those with chronic hip joint pain.ConclusionHip frontal plane motion was greater in those with chronic hip joint pain compared to those with patellofemoral pain. In both groups, greater abnormal movement at the respective joint (e.g. knee external rotation in the patellofemoral pain group and hip adduction and internal rotation in the chronic hip joint pain group) was associated with greater pain at that joint during a single leg squat.
| S-EPMC6738932 | biostudies-literature
Project description:OBJECTIVE:Examine associations of hip abductor strength with (1) cartilage damage worsening in the tibiofemoral and patellofemoral compartments 2 years later, and (2) poor function and disability outcomes 5 years later. METHODS:Participants had knee osteoarthritis (K/L ? 2) in at least one knee. Hip abductor strength was measured using Biodex Dynamometry. Participants underwent 3.0T MRI of both knees at baseline and 2 years later. Baseline-to-2-year cartilage damage progression, defined as any worsening of WORMS cartilage damage score, was assessed at each tibiofemoral and patellofemoral surface. LLFDI (Late-Life Function and Disability Instrument) and Chair-Stand-Rate were recorded at baseline and 5-year follow-up; outcomes analyzed using quintiles. Poor outcomes were defined as remaining in the same low-function quintiles or being in a worse quintile at 5-year follow-up. We analyzed associations of baseline hip abductor strength with cartilage damage worsening and function and disability outcomes using multivariable log-binomial models. RESULTS:275 knees from 164 persons [age = 63.7 (SD = 9.8) years, 79.3% women] comprised the structural outcome sample, and 187 persons [age = 64.2 (9.7), 78.6% women] the function and disability outcomes sample. Greater baseline hip abductor strength was associated with reduced risks of baseline-to-2-year medial patellofemoral and lateral tibiofemoral cartilage damage worsening [adjusted relative risks (RRs) range: 0.80-0.83) and with reduced risks of baseline-to-5-year poor outcomes for Chair-Stand-Rate and LLFDI Basic Lower-Extremity Function and Disability Limitation (adjusted RRs range: 0.91-0.94). CONCLUSION:Findings support a beneficial role of hip abductor strength for disease modification and for function and disability outcomes, and as a potential therapeutic target in managing knee osteoarthritis.
| S-EPMC6536333 | biostudies-literature
Project description:BackgroundKnee pain is studied mostly in older age groups, although in young adults it may be an indicator of future impaired musculoskeletal health. Therefore, the aim of this study was to examine the longitudinal association between knee pain and thigh muscle strength in young adult women and to explore the associations between muscle strength, body composition, physical activity and knee pain.MethodsThe PEAK-25 cohort consists of women aged 25 at baseline (N=1064). At the 10-year follow-up n=728 attended for DXA-measured body composition and muscle strength assessment and n=797 answered the questionnaire on health and lifestyle. Independent samples t-test was used to compare women with and without knee pain, Spearman correlation was used to test the longitudinal association between strength and knee pain.ResultsKnee pain was reported by one third of the women at follow-up (n=260, 33%), although physical activity levels were similar in those with and without pain (high level 50 vs 45 % (p= 0.18). Body composition differed, however. Women with knee pain had higher BMI (25.6 vs 24.1), fat mass index (9.2 vs 8.2) and % total body fat mass (34.7 vs 33.2). Simultaneously, they had lower % lean mass (total body 61.5 vs 62.8; legs 20.6 vs 21.0) and lower thigh muscle strength (extensors 184.9 vs 196.8, flexors 96.6 vs 100.9, p<0.05), but slightly higher hamstrings-to -quadriceps ratio (0.53 vs 0.51, p=0.04). Muscle strength at baseline weakly correlated with knee pain at follow-up (extensor rs= -0.04; flexor -0.02, p>0.2). Overweight women had higher absolute thigh muscle strength, but lower weight-adjusted strength than normal weight women (p<0.001). Leg lean mass explained 26-34% of the variation in muscle strength and adjustment for physical activity level had little effect.ConclusionKnee pain is already common among women in their mid-thirties. Lower thigh muscle strength in the mid-twenties was not associated with future knee pain, however women with knee pain tended to have lower thigh muscle strength and a body composition of higher body fat combined with lower lean mass. Maintaining a healthy body composition and adequate thigh muscle strength may be beneficial for knee joint health.
| S-EPMC8380389 | biostudies-literature
Project description:BackgroundThis study aimed to analyze the reliability of concentric isokinetic strength assessments (knee and hip) using the Biodex System 4 in healthy children and assess the association with functional strength tests (sit-to-stand [STS], lateral-step-up [LSU]).Methods19 children (6-12 years) were included. Knee and hip flexion and extension, and hip abduction and adduction were tested at 60 and 90°/s.ResultsRelative and absolute reliability at 60°/s tended to show better results compared to those at 90°/s. Intra class correlations (ICCs) of knee flexion and extension at 60°/s were good (0.79-0.89). For hip flexion, extension, abduction and adduction at 60°/s ICCs were moderate to good (0.53-0.83). The smallest detectable change (SDC) values (expressed in %) were highly variable. The SDC% for knee flexion and extension and hip abduction at 60°/s were around 50%. Positive associations were found between hip extension and abduction isokinetic strength and the STS test.ConclusionConcentric isokinetic strength assessments in healthy children using the Biodex System 4 were found reliable for knee flexion and extension and hip abduction. Limited associations were found between concentric isokinetic strength tests and functional strength tests.
| S-EPMC8907626 | biostudies-literature
Project description:Study designControlled laboratory cross-sectional study. Objectives To assess strength differences of the hip rotator and abductor muscle groups in young adults with chronic hip joint pain (CHJP) and asymptomatic controls. A secondary objective was to determine if strength in the uninvolved hip of those with unilateral CHJP differs from that in asymptomatic controls.BackgroundLittle is known about the relationship between hip muscle strength and CHJP in young adults.MethodsThirty-five participants with CHJP and 35 matched controls (18 to 40 years of age) participated. Using handheld dynamometry, strength of the hip external rotators and internal rotators was assessed with the hip flexed to 90° and 0°. To assess external rotator and internal rotator strength, the hip was placed at the end range of external rotation and internal rotation, respectively. Strength of the hip abductors was assessed in sidelying, with the hip in 15° of abduction. Break tests were performed to determine maximum muscle force, and the average torque was calculated using the corresponding moment arm. Independent-sample t tests were used to compare strength values between (1) the involved limb in participants with CHJP and the corresponding limb in the matched controls, and (2) the uninvolved limb in participants with unilateral CHJP and the corresponding limb in the matched controls.ResultsCompared to controls, participants with CHJP demonstrated weakness of 16% to 28% (P<.01) in all muscle groups tested in the involved hip. The uninvolved hip of 22 subjects with unilateral CHJP demonstrated weakness of 18% and 16% (P<.05) in the external rotators (0°) and abductors, respectively, when compared to the corresponding limb of the matched controls.ConclusionThe results of the present study demonstrate that persons with CHJP have weakness in the hip rotator and hip abductor muscles. Weakness also was found in the uninvolved hip of persons with CHJP.
| S-EPMC4216739 | biostudies-literature
Project description:Objectives. To investigate associations between muscle strength and pain sensitivity among healthy volunteers and associations between different pain sensitivity measures. Methods. Twenty-eight healthy volunteers (21 females) participated. Pressure pain thresholds (PPTs) were obtained from 1) computer-controlled pressure algometry on the vastus lateralis and deltoid muscles and on the infrapatellar fat pad and 2) computerized cuff pressure algometry applied on the lower leg. Deep-tissue pain sensitivity (intensity and duration) was assessed by hypertonic saline injections into the vastus lateralis, deltoid, and infrapatellar fat pad. Quadriceps and hamstring muscle strength was assessed isometrically at 60-degree knee flexion using a dynamometer. Associations between pain sensitivity and muscle strength were investigated using multiple regressions including age, gender, and body mass index as covariates. Results. Knee extension strength was associated with computer-controlled PPT on the vastus lateralis muscle. Computer-controlled PPTs were significantly correlated between sites (r > 0.72) and with cuff PPT (r > 0.4). Saline induced pain intensity and duration were correlated between sites (r > 0.39) and with all PPTs (r < -0.41). Conclusions. Pressure pain thresholds at the vastus lateralis are positively associated with knee extensor muscle strength. Different pain sensitivity assessment methods are generally correlated. The cuff PPT and evoked infrapatellar pain seem to reflect the general pain sensitivity. This trial is registered with ClinicalTrials.gov: NCT01351558.
| S-EPMC3791575 | biostudies-literature