The relationship between clinical measurements of lower extremity posture and tibial translation

Trimble, Mark H.; Bishop, Mark D.; Buckley, Bernadette D.; Fields, Laura C.; Rozea, G.

doi:10.1016/s0268-0033(02)00010-4

Cited by 79 publications

(77 citation statements)

References 15 publications

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“…In 1 study, 26 women averaged 5.86 6 4.26 of genu recurvatum and men averaged 3.26 6 1.56, values that are very close to our genu recurvatum values of 5.76 6 3.26 (women) and 3.16 6 2.56 (men). More than 106 of knee hyperextension has long been considered abnormal, a potential indicator of hyperlaxity in children with congenital hip dysplasia, and a risk factor for overuse injuries in the lower extremity.…”

Section: Discussionsupporting

confidence: 85%

“…The mean navicular drop (both measures) for both sexes in our study fell within minimum 26 and maximum 31 reported averages (7 and 9 mm, respectively). We did not observe a sex difference for the measure of tibial varum.…”

Section: Discussionsupporting

confidence: 79%

“…A particular problem with the measurement of static alignment measures is that intertester reliabilities typically are not consistently high. 21,26,40 We have attempted to avoid that problem by using a single tester, thereby maximally standardizing the measurement techniques. In our study, observed values fell within the ranges of average values reported in previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…All measures were collected using previously established methods. [22][23][24][25][26][27][28] For testing, participants were clothed in shorts that allowed exposure of all bony landmarks needed for testing and were barefoot. For all bony landmarks, the central point was palpated and marked with a fine-point marker.…”

Section: Lower Extremity Alignment Data Collectionmentioning

confidence: 99%

“…This method has been reported to have an ICC of 0.88 to 0.97 for intrarater reliability. 21,26 Anterior Pelvic Tilt. Anterior pelvic tilt was measured using previously described methods.…”

Section: Lower Extremity Alignment Data Collectionmentioning

confidence: 99%

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Sex Differences and Representative Values for 6 Lower Extremity Alignment Measures

McKeon

Hertel

2009

Journal of Athletic Training

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Context: A discrepancy in anterior cruciate ligament (ACL) injury rates exists between men and women. Structural differences between the sexes often are implicated as a factor in this discrepancy. Researchers anecdotally assume that men and women tend to display different normative values for certain lower extremity alignments, but published information about these values is limited.Objective: To evaluate the effect of sex on 6 measures of lower extremity alignment and to report representative values of these measures from a sample of active adults and elite athletes.Design: Descriptive cohort design. Setting: University research laboratory. Patients or Other Participants: A total of 118 healthy adults (57 men: age 5 21.1 6 3.0 years, height 5 179.1 6 7.3 cm, mass 5 79.8 6 13.0 kg; 61 women: age 5 20.0 6 1.6 years, height 5 167.7 6 6.7 cm, mass 5 62.7 6 5.5 kg) volunteered.Main Outcome Measure(s): Six common measures of lower extremity posture (navicular drop, tibial varum, quadriceps angle, genu recurvatum, anterior pelvic tilt, femoral anteversion) were collected using established methods. One measurement was taken for each participant for each lower extremity alignment. We measured the right lower extremity only.Results: Compared with men, women demonstrated larger quadriceps angles, more genu recurvatum, greater anterior pelvic tilt, and more femoral anteversion.Conclusions: We observed differences between men and women for 4 of the 6 lower extremity alignments that we measured. Future researchers should focus on identifying how sex and skeletal alignment affect biomechanical performance of functional tasks and what these differences specifically mean regarding the discrepancy in anterior cruciate ligament injury rates between the sexes.Key Words: malalignment, femoral anteversion, genu recurvatum, anterior pelvic tilt, quadriceps angle Key Points N Women demonstrated larger quadriceps angles, more genu recurvatum, greater anterior pelvic tilt, and more femoral anteversion compared with men.N We found no sex difference for navicular drop or tibial varum. N Because the sex differences for 4 measures of alignment were small, we cannot decisively conclude that alignment contributes to lower extremity injury.N Further investigation is needed to determine how lower extremity alignment affects the rate of lower extremity injuries.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Lower Extremity Alignment Data Collectionmentioning

confidence: 99%

“…This method has been reported to have an ICC of 0.88 to 0.97 for intrarater reliability. 21,26 Anterior Pelvic Tilt. Anterior pelvic tilt was measured using previously described methods.…”

Section: Lower Extremity Alignment Data Collectionmentioning

confidence: 99%

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Sex Differences and Representative Values for 6 Lower Extremity Alignment Measures

McKeon

Hertel

2009

Journal of Athletic Training

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Associations of Foot Posture and Function to Lower Extremity Pain: Results From a Population‐Based Foot Study

Riskowski

Dufour

Hagedorn

et al. 2013

Arthritis Care & Research

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Objective Studies have implicated foot posture and foot function as risk factors for lower extremity pain. Empirical population-based evidence for this assertion is lacking; therefore, the purpose of this study was to evaluate cross-sectional associations of foot posture and foot function to lower extremity joint pain in a population-based study of adults. Methods Participants were members of the Framingham Foot Study. lower extremity joint pain was determined by the response to the NHANES-type question, “On most days do you have pain, aching or stiffness in your [hips, knees, ankles, or feet]?” Modified Arch Index (MAI) classified participants as having planus, rectus (referent) or cavus foot posture. Center of Pressure Excursion Index (CPEI) classified participants as having over-pronated, normal (referent) or over-supinated foot function. Crude and adjusted (age, gender, BMI) logistic regression determined associations of foot posture and function to lower extremity pain. Results Participants with planus structure had higher odds of knee (1.57, 95% CI: 1.24– 1.99) or ankle (1.47, 95% CI: 1.05–2.06) pain, whereas those with a cavus foot structure had increased odds of ankle pain only (7.56, 95% CI: 1.99–28.8) and pain at one lower extremity site (1.37, 95% CI: 1.04–1.80). Associations between foot function and lower extremity joint pain were not statistically significant, except for a reduced risk of hip pain in those with an over-supinated foot function (0.69, 95% CI: 0.51–0.93). Conclusions These findings offer a link between foot posture and lower extremity pain, highlighting the need for longitudinal or intervention studies.

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Sex differences in coupled knee motions during the transition from non‐weight bearing to weight bearing

Shultz

Beynnon

Schmitz

2009

Journal Orthopaedic Research

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Knee ligament injuries frequently happen when the joint transitions from non-weight bearing (NWB) to weight bearing (WB). To gain insight into the mechanism that produces these injuries, physically active females (N ¼ 41) and males (N ¼ 39) underwent measurement of coupled tibiofemoral joint displacements [anterior tibial translation (ATT) and varus-valgus and internal-external rotations] and neuromuscular responses as the knee transitioned from NWB to WB in response to a 40% body weight load applied under the control of gravity. The transition from NWB to WB produced no difference in ATT between males and females; however, significant sex-based differences were noted for both transverse and frontal plane knee motions. With the knee NWB, females were in a greater absolute valgus compared to males (6.6 vs. 5.08), and moved through greater varus motion than males during the transition from NW to WB (2.3 vs. 1.48), resulting in similar valgus alignment for both sexes at peak WB (4.3 vs. 3.68). In the transverse plane, the knees of females were positioned in more external rotation compared to males when NWB (1.4 vs. À0.38), then females externally rotated their knees while males internally rotated their knees during the transition from NWB to WB. This resulted in a 3.48 difference in transverse plane knee position at peak WB (2.3 vs. À1.18). Our findings suggest that the coupled knee motions produced during the transition from NWB to WB are sex dependent, and may provide insight into the knee motion patterns that place females at increased risk of knee ligament injury. ß

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The relationship between clinical measurements of lower extremity posture and tibial translation

Cited by 79 publications

References 15 publications

Sex Differences and Representative Values for 6 Lower Extremity Alignment Measures

Sex Differences and Representative Values for 6 Lower Extremity Alignment Measures

Associations of Foot Posture and Function to Lower Extremity Pain: Results From a Population‐Based Foot Study

Sex differences in coupled knee motions during the transition from non‐weight bearing to weight bearing

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