Journal of Research in Rehabilitation Sciences

The Comparison of the Pattern and Activity of Selected Muscles of the Lower Extremity in Athletes with Genu Varum and Healthy Athletes during Running: A Case-Control Study

Document Type : Original Articles

Authors

1 MSc Student, Department of Sport Biomechanics, School of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran

2 Professor, Department of Sport Biomechanics, School of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran

3 Assistant Professor, Department of Sport Biomechanics, School of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran

10.22122/jrrs.v12i5.2754

Abstract

Introduction: Malalignment of the lower extremity, especially at the knee, can lead to injury due to its impact on muscle activity. Therefore, the aim of the present study was to compare the pattern and activity of selected muscles of the lower extremity in athletes with genu varum and healthy athletes during running.Materials and Methods: The present quasi-experimental study was conducted on 30 male athletes (two groups of genu varum and healthy) with the age range of 20-25 years. The amount and the time of onset of muscle activity were calculated using electromyography (EMG). To evaluate differences between and within groups, MANOVA and paired samples t-test were utilized, respectively, at the 0.05 level of significance. Data were analyzed in MATLAB and SPSS software.Results: The results showed that the gluteus medius muscle in the athletes with genu varum had significantly higher levels of activity compared to the control group in the dominant (P = 0.032) and non-dominant limbs (P = 0.039). However, the rectus femoris and medial gastrocnemius muscles’ activity was not significantly different between the two groups (P > 0.050). In addition, there was no significant difference between the groups in terms of onset of muscle activity (P > 0.050). Moreover, no significant difference was observed between dominant and non-dominant limbs in the amount and onset of muscle activity (P > 0.050).Conclusion: Based on the results of this study, it can be concluded that the gluteus medius muscle had greater activity in subjects with genu varum deformity than healthy subjects. This increase in activity can be accompanied with increase in compressive forces and articular loads which can cause osteoarthritis in the long run.

Keywords

  1. Lusardi M, Jorge M, Nielsen C. Orthotics and prosthetics in rehabilitation. 3rd ed. Philadelphia, PA: Saunders; 2012. p. 527-41.
  2. Levangie PK, Norkin CC. Joint structure and function: A comprehensive analysis. 5th ed. Philadelphia, PA: F.A. Davis; 2011.
  3. Twomey D, McIntosh AS, Simon J, Lowe K, Wolf SI. Kinematic differences between normal and low arched feet in children using the Heidelberg foot measurement method. Gait Posture 2010; 32(1): 1-5.
  4. Murphy DF, Connolly DA, Beynnon BD. Risk factors for lower extremity injury: A review of the literature. Br J Sports Med 2003; 37(1): 13-29.
  5. Chaudhari AM, Andriacchi TP. The mechanical consequences of dynamic frontal plane limb alignment for non-contact ACL injury. J Biomech 2006; 39(2): 330-8.
  6. Neely FG. Biomechanical risk factors for exercise-related lower limb injuries. Sports Med 1998; 26(6): 395-413.
  7. Van Gheluwe B, Kirby KA, Hagman F. Effects of simulated genu valgum and genu varum on ground reaction forces and subtalar joint function during gait. J Am Podiatr Med Assoc 2005; 95(6): 531-41.
  8. Marks R, Percy JS, Semple J, Kumar S. Quadriceps femoris activation changes in genu varum: a possible biomechanical factor in the pathogenesis of osteoarthrosis. J Theor Biol 1994; 170(3): 283-9.
  9. Stief F, Bohm H, Schwirtz A, Dussa CU, Doderlein L. Dynamic loading of the knee and hip joint and compensatory strategies in children and adolescents with varus malalignment. Gait Posture 2011; 33(3): 490-5.
  10. Ramsey DK, Snyder-Mackler L, Lewek M, Newcomb W, Rudolph KS. Effect of anatomic realignment on muscle function during gait in patients with medial compartment knee osteoarthritis. Arthritis Rheum 2007; 57(3): 389-97.
  11. Silvers HJ, Mandelbaum BR. ACL Injury Prevention in the Athlete. Sports Orthopaedics and Traumatology 2011; 27(1): 18-26.
  12. Borghuis J, Hof AL, Lemmink KA. The importance of sensory-motor control in providing core stability: Implications for measurement and training. Sports Med 2008; 38(11): 893-916.
  13. Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Med 2006; 36(3): 189-98.
  14. Baratta R, Solomonow M, Zhou BH, Letson D, Chuinard R, D'Ambrosia R. Muscular coactivation. The role of the antagonist musculature in maintaining knee stability. Am J Sports Med 1988; 16(2): 113-22.
  15. Hewett TE, Zazulak BT, Myer GD, Ford KR. A review of electromyographic activation levels, timing differences, and increased anterior cruciate ligament injury incidence in female athletes. Br J Sports Med 2005; 39(6): 347-50.
  16. Namavarian N, Rezasoltani A, Rekabizadeh M. A study on the function of the knee muscles in genu varum and genu valgum. J Mod Rehabil 2014; 8 (3): 1-9. [In Persian].
  17. Ravaud P, Chastang C, Auleley GR, Giraudeau B, Royant V, Amor B, et al. Assessment of joint space width in patients with osteoarthritis of the knee: A comparison of 4 measuring instruments. J Rheumatol 1996; 23(10): 1749-55.
  18. Palastangan N, Field D, Soames R. Anatomy and human movement. 6th ed. Philadelphia, PA: Elsevier; 2006.
  19. Murley GS, Landorf KB, Menz HB, Bird AR. Effect of foot posture, foot orthoses and footwear on lower limb muscle activity during walking and running: A systematic review. Gait Posture 2009; 29(2): 172-87.
  20. Park S, Chung JS, Kong YS, Ko YM, Park JW. Differences in onset time between the vastus medialis and lateralis during stair stepping in individuals with genu varum or valgum. J Phys Ther Sci 2015; 27(9): 2727-30.
  21. Riemann BL, Lephart SM. The sensorimotor system, part I: the physiologic basis of functional joint stability. J Athl Train 2002; 37(1): 71-9.
  22. Patrek MF, Kernozek TW, Willson JD, Wright GA, Doberstein ST. Hip-abductor fatigue and single-leg landing mechanics in women athletes. J Athl Train 2011; 46(1): 31-42.
  23. Russell KA, Palmieri RM, Zinder SM, Ingersoll CD. Sex differences in valgus knee angle during a single-leg drop jump. J Athl Train 2006; 41(2): 166-71.
  24. Cowan SM, Bennell KL, Hodges PW, Crossley KM, McConnell J. Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome. Arch Phys Med Rehabil 2001; 82(2): 183-9.
  25. Hinman RS, Bennell KL, Metcalf BR, Crossley KM. Delayed onset of quadriceps activity and altered knee joint kinematics during stair stepping in individuals with knee osteoarthritis. Arch Phys Med Rehabil 2002; 83(8): 1080-6.
  26. Park S, Kong YS, Ko YM, Jang GU, Park JW. Differences in onset timing between the vastus medialis and lateralis during concentric knee contraction in individuals with genu varum or valgum. J Phys Ther Sci 2015; 27(4): 1207-10.
  27. Javdaneh N, Minoonejad H, Shirzad E, Javdaneh N. The investigation of the muscle timing of anterior cruciate ligament agonist and antagonist muscles in athletes with hyper pronated feet. J Mil Med 2016; 17(4): 257-64. [In Persian].
  28. Beckman SM, Buchanan TS. Ankle inversion injury and hypermobility: effect on hip and ankle muscle electromyography onset latency. Arch Phys Med Rehabil 1995; 76(12): 1138-43.
  29. Arjunan SP, Kumar DK. Age-associated changes in muscle activity during isometric contraction. Muscle Nerve 2013; 47(4): 545-9.
  30. Barati A, Mosavi SK. The Effect of various standing positions in muscles activity between healthy young men and those with genu varum. Journal of Sport Biomechanics 2014; 1(1): 53-61. [In Persian].
  31. Anbarian M, Esmailie H, Hosseini Nejhad SE, Rabiei M, Binabaji H. Comparison of knee joint muscles' activity in subjects with genu varum and the controls during walking and running. J Res Rehabil Sci 2012; 8(2): 298-309. [In Persian].
  32. Heiden TL, Lloyd DG, Ackland TR. Knee joint kinematics, kinetics and muscle co-contraction in knee osteoarthritis patient gait. Clin Biomech (Bristol, Avon) 2009; 24(10): 833-41.
  33. Tsakoniti AE, Stoupis CA, Athanasopoulos SI. Quadriceps cross-sectional area changes in young healthy men with different magnitude of Q angle. J Appl Physiol (1985) 2008; 105(3): 800-4.
  34. Mahaki M, Shojaedin s, Memar R, Khaleghi Nazji M. The comparsion of the electromyography of leg muscles and peak vertical ground reaction forces during single leg drop landing between men with genu varum deformity and normal Knee. Journal of Sport Medicine 2013; 4(2): 87-106. [In Persian]
  35. Musavi SK, Shojaedin SS, Memar R. The comparsion of peak vertical ground reaction forces and leg muscles electromyography during single leg drop landing between men with genu varum deformity and normal knee from different height. Journal of Sport Medicine 2014; 6(2): 167-87. [In Persian].
  36. Jacobs CA, Uhl TL, Mattacola CG, Shapiro R, Rayens WS. Hip abductor function and lower extremity landing kinematics: sex differences. J Athl Train 2007; 42(1): 76-83.
  37. Neumann DA. Kinesiology of the musculoskeletal system: Foundations for rehabilitation. 3rd ed. Philadelphia, PA: Mosby; 2016.
  38. Chumanov ES, Wall-Scheffler C, Heiderscheit BC. Gender differences in walking and running on level and inclined surfaces. Clin Biomech (Bristol, Avon) 2008; 23(10): 1260-8.
  39. Junge A, Dvorak J. Soccer injuries: a review on incidence and prevention. Sports Med 2004; 34(13): 929-38.
  40. Mann RA, Haskell A. Biomechanics of the foot and ankle. In: Coughlin MJ, Mann RA, Saltzman CL, editors. Surgery of the foot and ankle. 6th ed. Philadelphia. PA: Mosby; 1993. p. 29.
  41. Gstottner M, Neher A, Scholtz A, Millonig M, Lembert S, Raschner C. Balance ability and muscle response of the preferred and nonpreferred leg in soccer players. Motor Control 2009; 13(2): 218-31.
Journal of Research in Rehabilitation Sciences
Volume 12, Issue 5 - Serial Number 5
January 2017
Pages 274-282