misalignment on proximal joints; 10 it was hypothesized that the assessment of the entire lower limb alignment in different foot types might be utilized as a clinical tool and, therefore, could be used for preventing consequent lower limb injuries. 5 , 7 , 11 – 13 The increasing incidence rate, with
Figen Govsa, Gkionoul Nteli Chatzioglou, Simin Hepguler, Yelda Pinar and Ozden Bedre
David Werner, John Willson, Richard Willy and Joaquin Barrios
Frontal plane knee alignment can influence the development and management of various knee pathologies. Valid and reliable clinical methods for assessment are needed. The primary purposes of this study were to assess the validity and reliability of inclinometer-based frontal plane tibial orientation as a limb alignment measure, and secondarily to establish normal values in healthy individuals. Frontal tibial orientation was validated per moderately strong correlation to radiographic knee alignment. Intra- and interrater reliability were excellent. The normative mean was approximately 7°. In summary, inclinometer-based frontal tibial orientation is a valid and reliable clinical measure of frontal plane knee alignment.
Rodrigo de M. Baldon, Daniel F.M. Lobato, Leonardo Furlan and Fábio Serrão
The purpose of this study was to compare lower limb kinematics between genders during stair descent. Fifteen females and fifteen males who were healthy and active were included in this study. The lower limb kinematics (pelvis, femur and knee) in the coronal and transversal planes were assessed during stair descent at 30°, 40°, 50° and 60° of knee flexion. The study found that females showed greater knee medial rotation for all the knee flexion angles (P = .02−.001), greater femoral adduction (P = .01 for all variables), with exception for 30° (P = .13), and greater femoral lateral rotation at 60° (P = .04). Females also showed a trend to have greater knee valgus at all the knee flexion angles (P = .06−.11) as well as less contralateral pelvis elevation at 50° and 60° (P = .10 and .12, respectively). This study showed that females carry out the stair descent with a lower limb alignment that might predispose them to develop overuse knee injuries, such as the iliotibial band syndrome and patellofemoral pain syndrome. Further prospective investigations should be carried out to verify whether these variables are factors that could predict these knee injuries.
Arnel Aguinaldo and Andrew Mahar
This study evaluated the effects of running shoes—with two types of cushioning column systems—on impact force patterns during running. Kinematic and ground reaction force data were collected from 10 normal participants wearing shoes with the following cushions: 4-column multicellular urethane elastomer (Shoe 1), 4-column thermoplastic polyester elastomer (Shoe 2), and 1-unit EVA foam (Shoe 3). Participants exhibited significantly lower impact force (p = .02) and loading rate (p = .005) with Shoe 2 (1.84 ± 0.24 BW; 45.6 ± 11.6 BW/s) compared to Shoe 1 (1.94 ± 0.18 BW; 57.9 ± 12.1 BW/s). Both cushioning column shoes showed impact force characteristics similar to those of a top-model running shoe (Shoe 3), and improved cushioning performance over shoes previously tested in similar conditions. Alterations in impact force patterns induced by lower limb alignment and running speed were negligible since participants did not differ in ankle position, knee position, or speed during all shod running trials. Ankle plantarflexion, however, was higher for barefoot running, indicating an apparent midfoot strike. Mechanical testing of each shoe during physiologic, cyclic loading demonstrated that Shoe 3 had the greatest stiffness, followed by Shoe 2 and Shoe 1. Shoe 1 was the least stiff of the two shoes with cushioning column systems, yet it displayed a significantly higher impact loading rate during running, possibly due to rearfoot motion alterations induced by the stiffer shoe. This study showed that even in similar shoe types, impact force and loading rate values could vary significantly with midsole cushion constructions. The findings of this study suggest that using these newer running shoes may be effective for runners who want optimal cushioning during running.
Bernard Liew, Kevin Netto and Susan Morris
performed in the landing phase, as compared to a landing where lower limb alignment was more extended (ie, less muscular component of leg stiffness). 41 When translated into running at velocities faster than an individual’s preferred pace, the greater muscular component to leg stiffness may keep the
Peter Francis, Kay Gray and Nic Perrem
in stabilizing the trunk and pelvis. The hip abductors maintain lower limb alignment through reducing accelerations of the center of mass in the sagittal and frontal plane in response to postural perturbations. 3 , 4 Compared to healthy controls, individuals with lower extremity injury such as
Eric Foch and Clare E. Milner
variability in female runners with a history of ITBS. Acknowledgment The authors have no conflicts of interest to disclose. References 1. Lun V , Meeuwisse WH , Stergiou P , Stefanyshyn D . Relation between running injury and static lower limb alignment in recreational runners . Br J Sports Med
Tsuyoshi Saida, Masayuki Kawada, Daijiro Kuroki, Yuki Nakai, Takasuke Miyazaki, Ryoji Kiyama and Yasuhiro Tsuneyoshi
knee kinematics three months after total knee replacement . Gait & Posture, 41 ( 2 ), 624 – 629 . PubMed ID: 25701011 doi:10.1016/j.gaitpost.2015.01.010 10.1016/j.gaitpost.2015.01.010 Andrews , M. , Noyes , F.R. , Hewett , T.E. , & Andriacchi , T.P. ( 1996 ). Lower limb alignment and foot
Sarah P. Shultz, Jinsup Song, Andrew P. Kraszewski, Jocelyn F. Hafer, Smita Rao, Sherry Backus, Rajshree M. Hillstrom and Howard J. Hillstrom
Royal Australian Air Force recruits. Part 1: prospective cohort study . Mil Med. 2005 ; 170 ( 7 ): 623 – 628 . PubMed doi: 10.7205/MILMED.170.7.623 16130646 4. Carvalho ACA , Hespanhol LC , Costa LOP , Lopes AD . The association between runners’ lower limb alignment with running
Anis Rostami, Amir Letafatkar, Alli Gokeler and Mehdi Khaleghi Tazji
. doi:10.1016/j.clinbiomech.2006.07.004 10.1016/j.clinbiomech.2006.07.004 47. Andrews M , Noyes FR , Hewett TE , Andriacchi TP . Lower limb alignment and foot angle are related to stance phase knee adduction in normal subjects: a critical analysis of the reliability of gait analysis data