Pelvic, Hip, and Knee Kinematics of Stair Climbing in People with Genu Varum

PURPOSE: This study examined the effects of the lower limb alignment on the pelvis, hip, and knee kinematics in people with genu varum during stair walking. METHODS: Forty subjects were enrolled in this study. People who had intercondylar distance ≥4cm were classified in the genu varum group, and people who had intercondylar distance < 4cm and intermalleolar distance < 4cm were placed in the control group. 3D motion analysis was used to collect the pelvis, hip, and knee kinematic data while subjects were walking stairs with three steps. RESULTS: During stair ascent, the genu varum group had decreased pelvic lateral tilt and hip adduction at the early stance phase and decreased pelvic lateral tilt at the swing phase compared to the control group. At the same time, they had decreased minimal hip adduction ROM at the early stance and decreased maximum pelvic lateral tilt ROM and minimum hip rotation ROM at the swing phase. During stair descent, the genu varum group had decreased pelvic lateral tilt at the early stance and decreased pelvic lateral tilt and pelvic rotation at the swing phase. In addition, they had decreased pelvic frontal ROM during single limb support and increased knee sagittal ROM during the whole gait cycle. CONCLUSION: This study suggests that a genu varum deformity could affect the pelvis, hip and knee kinematics. In addition, the biomechanical risk factors that could result in the articular impairments by the excessive loads from lower limb malalignment were identified.

The Effect of a Proximal and Distal Tibiofibular Joint Manipulation on Dorsiflexion and Balance in Individuals with a History of Lateral Ankle Sprain

PURPOSE: This study aimed to evaluate the changes in dorsiflexion and balance following proximal and distal tibiofibular joint manipulation in individuals with a history of lateral ankle sprain (LAS). METHODS: Fifteen participants with a history of unilateral LAS, exhibiting a restriction in ankle dorsiflexion were included in this study. LAS ankle received a manipulation to the proximal and distal tibiofibular joint, while the opposite control ankle received no manipulation intervention. The outcome measures included ankle dorsiflexion and balance. Ankle dorsiflexion was measured using weight-bearing lunge test. Static and dynamic balances were measured using the overall, anterioposterior, and mediolateral balance index via the biodex balance system. Measurements were obtained prior to and following manipulation. RESULTS: This study showed that ankle dorsiflexion and dynamic balance were improved following the manipulation compared to those prior to the manipulation (p0.05). CONCLUSION: The joint manipulation technique applied to the ankle of those with a history of LAS appears to improve ankle dorsiflexion and dynamic balance. This suggest that a manipulation to the proximal and distal tibiofibular joint could be provided as preliminary data regarding the prophylactic effects of recurrent LAS.

Reduction of Spinal Cyclooxygenase-2 with Transcutaneous Electrical Nerve Stimulation and Cold Therapy in Rats of Carrageenan-induced Inflammatory Muscle Pain / 대한해부학회지

The purpose of this study was to investigate the effects of transcutaneous electrical nerve stimulation (TENS) and cold therapy on cyclooxygenase-2 (COX-2) expression in lumbar spinal cord and on secondary hyperalgesia produced by muscle pain. Muscle pain was experimentally induced by injection of 2% carrageenan into gastrocnemius muscle of Sprague-Dawley rats. For assessment of secondary hyperalgesia, the rats were tested for paw withdrawal latency (PWL) and tail flick latency (TFL) to heat stimulus. COX-2 expression in lumbar cord was examined using RT-PCR and immunohistochemistry. Secondary hyperalgesia to heat stimulus was significantly reduced in the both TENS- and cold-treatment groups, compared to the control group. The COX-2 mRNA levels were down-regulated in the lumbar spinal cord in the both TENS- and cold-treatment groups. In addition, COX-2 immunoreactivity was decreased in the dorsal horn of the lumbar spinal cord in the both TENS- and cold-treatment groups. These results suggested that decreased COX-2 expression in the lumbar spinal cord of the subjects receiving TENS treatment and cold therapy might be an important factor for reducing secondary hyperalgesia produced by muscle pain.