[Evaluation of alignment on knees through a software]. / Evaluación de la alineación en rodillas mediante un software.

INTRODUCTION: Diseases of the musculoskeletal system are often accompanied by postural deformity or malalignment. Genu varo or genu valgo can be found in the knees. It is necessary to have a diagnostic support test for diagnosis as well as for follow-up of cases since these diseases are frequently progressive and over time have serious repercussions on patient quality of life. Objective. To evaluate a software program that processes digitalized photographs as a diagnostic test for measuring the mechanical axis in patients with genu varo and genu valgo. MATERIALS AND METHODS: The mechanical axis in both knees was measured by means of radiography (golden standard) and by means of a software program (proposed diagnostic test) in one hundred patients. Mechanical axis was considered to be abnormal when the angle was equal to or greater than four degrees. Sensitivity, specificity, positive predictive value, and negative predictive value were determined. Interobserver variation was evaluated with kappa statistics. RESULTS: In relation to right knee genu varo, sensitivity, specificity, positive predictive value, and negative predictivie value were 0.84, 0.87, 0.84, and 0.87, respectively, and for the left knee values were 0.86, 0.87, 0.84, and 0.89, respectively. For genu valgo in the right knee, sensitivity, specificity, positive predictive value, and negative predictive value were 0.78, 0.98, 0.95, and 0.92, respectively, and in the left knee were 0.88, 0.95, 0.88, and 0.95, respectively. Kappa value was 0.9 in the right knee and 0.8 in the left knee. CONCLUSION: The software program (diagnostic test) was useful for diagnosing genu varo or genu valgo, representing a safe and low-cost study.

[Comparison of three therapeutic exercises protocols to lumbar hyperlordosis improvement in asyntomatic youths]. / Comparación de tres protocolos de ejercicios terapéuticos para corrección de la hiperlordosis lumbar en jóvenes asintomáticos.

INTRODUCTION: One of the causes of low back pain is lumbar hyperlordosis. There are different protocols of therapeutic exercises for its correction, which do not involve all of corporal segments. A modified protocol is proposed, which involves all such segments. OBJECTIVE: To evaluate the efficacy of proposed protocol with two established protocols for correction of lumbar hyperlordosis. MATERIALS AND METHODS: Simple-blind clinical trial on 42 students of the Faculty of Medicine at University of Colima. The three protocols: A) Pérez-Olmedo (proposed, n = 14), B) Williams (n = 15) and C) Jeffrey Saal (n = 13) were randomly assigned. Clinical and radiological evaluations were performed. Lumbar hyperlordosis was considered when Ferguson's angle was > or = 30 degrees, measured on lateral spine x-ray pictures. During two months they underwent supervised and directed exercise sessions. The improvement in lumbar hyperlordosis correction of each protocol was compared through paired Student t-test and ANOVA. RESULTS: Average age was 18 +/- 0.9 years. Lumbar hyperlordosis frequency was 31% (n = 15). There was not significative difference on Ferguson's angle average comparation between three treatment groups. There was lumbar hyperlordosis improvement with following percentages: group A = 60%, Group B = 16% and group C = 0%. CONCLUSION: Protocol of therapeutic exercises proposed (Pérez-Olmedo) could be an alternative to lumbar hyperlordosis improvement in asyntomatic youhts.