Effect of Corrective Exercises on Dynamic Knee Valgus

Condition(s) studied

Investigational drug(s) / intervention(s)

Exercise: Education on activities of daily living will be provided. In addition, a program including muscle strengthening, neuromuscular control and flexibility exercises for lower extremity and trunk muscles will be performed. Exercise Program will be performed for 8 weeks, 2 sessions per week.

Control: Education will be provided for activities of daily living. Individuals with dynamic knee valgus in the control group will not receive any intervention. Exercise program will be implemented after the end of the study.

Study summary

Dynamic knee valgus (DKV) is a movement pattern of the lower limb potentially consisting of a combination of adduction and internal rotation of the femur, knee abduction, tibial anterior translation, tibial external rotation and ankle eversion. Average "normal" performance during a fall jump landing mission knee valgus angle should be in the range of 7-13 degrees in women and 3-8 degrees in men. This faulty movement pattern is a common dysfunction observed in the lower limb during dynamic activities. On the other hand, this is reported to be the underlying mechanism of knee injuries. Changes in knee valgus increase abnormal stresses on the tibiofemoral joint and increase the risk of injuries such as anterior cruciate ligament injuries, patellofemoral pain, iliotibial band syndrome, chronic ankle instability, acute lateral ankle sprains. The main cause of DKV is deficits in neuromuscular control and therefore injury prevention and rehabilitation strategies focus on improving neuromuscular control to avoid these injury mechanisms. There are conflicting results in the literature regarding which of the exercise approaches is superior for DKV, and there is a lack of studies evaluating 2D movement analysis, muscle mechanics and performance of corrective exercise training. Identifying individuals with abnormal movement patterns and those at risk is important to prevent future injuries. The aim of the study was to investigate the effect of corrective exercises on lower extremity biomechanics and performance in individuals with asymptomatic dynamic knee valgus.

Eligibility

Primary outcome measure(s)

• Frontal plan projection angle evaluation — Before the intervention, up to 8 weeks
  It will be evaluated with the Single Leg Drop Jump test. Kinovea® 2D motion two-dimensional video analysis software will be used to measure the knee-valgus/varus anterior plane projection angle (FPPA).
• Single leg squat test — Before the intervention, up to 8 weeks
  During the test, they will be asked to perform a single-leg squat from a static position to at least 60° knee flexion and then return to the starting position. Kinovea® 2D motion two-dimensional video analysis software will be used for the measurement.
• Viscoelastic properties of muscle — Before the intervention, up to 8 weeks
  The viscoelastic properties of the participants' muscle will be measured using a myotonometer (MyotonPRO, Tallinn, Estonia). It will be performed on the quadriceps, hamstring, gastrocnemius and hip adductor muscles. Individuals will be asked to contract the muscle and the center of the muscle mass will be identified and marked. The muscle will then be asked to relax. For the measurement, the probe is placed over the muscle, perpendicular to the skin surface, and mechanical force is applied to the subcutaneous tissue for a constant 15 milliseconds. The interval between each pulse is 8 ms and 5 pulses.

Trial sites (1)

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