Development of garment with elastic straps and pressure applicator in mechanotherapy to correct children’s genu valgum

Abstract

Objective: Genu valgum (GV), also known as valgus knee, or knock-knee, is a common orthopaedic condition in growing children. Physiological genu valgum have intermalleolar distance of up to 8 cm, the greatest distance being observed between 3 and 4 years, disappearing gradually after the age of 7-8 years. If the longitudinal axis of the knee joint is not aligned by then, physiotherapeutic intervention is called for. Aim:The aim of our study was to determine if garment with elastic straps and pressure applicator could be used in mechanotherapy to correct children's excessive GV. Methods:The study has lasted last 6 years and there has been three study periods. In all study-periods, practical part lasted six months. Inclusion criterias were: subjects were not involved in physical therapy and did not wear orthoses during the study. Once in every month myometric values (tone, biomechanical and viscoelastic properties of m. sartorius, tensor fasciae latae, semitendinosus, tibialis anterior, gastrocnemius caput mediale, m. peroneus longus) were determined with MyotonPro (Myoton AS, Estonia); anthropometric (height, body mass, intermalleolar distance), and goniometric (tibiofemoral angle) parameters were measured according to the standard technique. During the last three months children didn't wear garment and final measurement was done to evaluate long term effect of garment. Individual analysis was carried out to evaluate the results. Results:After wearing the garments with pressure and elastic components the changes in the lower limb joint alignment and biomechanical parameters promoted the correction of GV position. Three months after the wearing period the changes occurred the worsening of GV position, which indicates that the muscles could not maintain the condition achieved by wearing the garment. Conclusion:The relationship between applied mechano therapeutic stimulus and changes in the lower limb joint alignment and changes of the biomechanical parameters are individual. Study continues with upgrading a device where a new solution is found using digital technology to measure tensile strength at a desired period.

Development of Garments with Elastic Straps and Pressure Applicator (GESPA) and “GVcorrect” App to Follow the Changes in Lower-Extremity Alignment (Genu Valgum)—A Pilot Study

“…The changes in muscle tone studied during both the GESPA wearing period and the non-wearing period were statistically significant (p < 0.05). Biomechanical parameters (frequency, logarithmic decrement, stiffness) in AII showed individual and mostly positive changes as described in previous article (Tamm et al, 2018). For example, the frequency of m. sartorius (Figure 4) and m. tensor fascia latae (Figure 6) increased (p < 0.05) with wearing GESPA.…”

“…For example, subject I had low level of the pressure (approximately 550 mN) and the decrease of frequency of m. tensor fascia latae during the GESPA wearing period was low. Biomechanical parameters (frequency, logarithmic decrement, stiffness) in AII showed individual and mostly positive changes as described in previous article (Tamm et al, 2018). For example, the frequency of m. sartorius (Figure 4) and m. tensor fascia latae (Figure 6) increased (p < 0.05) with wearing GESPA.…”

“…The children claimed that the GESPA was uncomfortable for the following reasons: the GESPA sank and the need to adjust them tightly (n = 4); the discomfort above the knee joint (n = 4); the fastening on the midfoot bothered when put on the shoes (n = 4); wearing GESPA caused feeling of warmth (n = 4); garments did not fit in overweight subject due to their apple type body shape (n = 1). However, one third of parents (n = 2) claimed that the child was eager to wear GESPA Biomechanical parameters (frequency, logarithmic decrement, stiffness) in AII showed individual and mostly positive changes as described in previous article (Tamm et al, 2018). For example, the frequency of m. sartorius (Figure 4) and m. tensor fascia latae (Figure 6) increased (p < 0.05) with wearing GESPA.…”

“…There are also non-invasive methods of correcting GV (incl methods the principle of kinesio-tape; TheraTogs Ultra), but until now, there is no method to evaluate mechanotherapeutic intervention that does not restrict the child's natural movements while the process is on-going so that timely decisions could be made on the effectiveness of the intervention. Scientists in Tartu Health Care College in collaboration with University of Tartu and The Health Clinic have been studied garments with elastic straps and pressure applicator (GESPA) [19,20] in children with genu valgum since 2014. The aim of this studyperiod (2020) was to develop and assess the comfortability of GESPA and the reliability and user-friendliness of "GVcorrect" app, which aims to catch the GESPA' elastic straps pressure level (mN).…”