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Lucha-López MO, Tricás-Moreno JM, Gaspar-Calvo E, Lucha-López AC, Vidal-Peracho C, Hidalgo-García C, Caudevilla-Polo S, Fanlo-Mazas P. Relationship between knee alignment in asymptomatic subjects and flexibility of the main muscles that are functionally related to the knee. J Int Med Res 2018; 46:3065-3077. [PMID: 29936873 PMCID: PMC6134663 DOI: 10.1177/0300060518771825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To assess the relationship between static frontal knee alignment in asymptomatic subjects and flexibility of the main muscles functionally related to the knee. Methods A descriptive cross-sectional study was performed in 33 healthy adults (19-31 years). The frontal knee angle (valgus/varus angle) was measured by photogrammetry and it was measured in the lateral side. Therefore, high values were assigned for genu varum and low values for genu valgum. Iliopsoas, gluteus maximus and medius, rectus femoris, biceps femoris, vastus of the quadriceps, and gastrocnemius muscles were stretched. Muscles were classified as normal, reflex hypomobile, or structural hypomobile. Results Women had significantly greater valgus than did men (right angle, women: 174.41°/men: 177.41°; left angle, women: 174.20°/men: 178.70°). The right frontal plane knee angle was higher in women with structural hypomobile vastus. The left frontal plane knee angle was higher in women with structural hypomobile iliopsoas. No relationships were found in men. Conclusions A tighter vastus of the quadriceps and tighter iliopsoas are related to greater genu varum in adult women. Stretching the vastus of the quadriceps and iliopsoas when there is a tendency for excess varus in the knee, to prevent overuse injury or early osteoarthritis, might be clinically relevant.
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Affiliation(s)
- María Orosia Lucha-López
- 1 Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Spain
| | - José Miguel Tricás-Moreno
- 1 Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Spain
| | - Elena Gaspar-Calvo
- 1 Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Spain
| | - Ana Carmen Lucha-López
- 1 Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Spain
| | - Concepción Vidal-Peracho
- 2 Specialty Medical Center Grande Covián, SALUD, Avda. Alcalde Caballero Zaragoza, Spain.,3 Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Spain
| | - César Hidalgo-García
- 1 Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Spain
| | - Santos Caudevilla-Polo
- 1 Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Spain
| | - Pablo Fanlo-Mazas
- 1 Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Spain
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Scarr G. Fascial hierarchies and the relevance of crossed-helical arrangements of collagen to changes in shape; part II: The proposed effect of blood pressure (Traube-Hering-Mayer) waves on the fascia. J Bodyw Mov Ther 2016; 20:629-38. [PMID: 27634089 DOI: 10.1016/j.jbmt.2015.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 09/04/2015] [Accepted: 10/20/2015] [Indexed: 01/14/2023]
Abstract
Periodic changes in arterial pressure and volume have long been related to respiratory and sympathetic nerve activity (Traube-Hering-Mayer waves) but their origins and nomenclature have caused considerable confusion since they were first discovered in the eighteenth century. However, although they remain poorly understood and the underlying details of their control are complicated, these waves do provide valuable clinical information on the state of blood pressure regulation in both normal and pathological conditions; and a correlation with oscillatory motions observed by certain practitioners suggests that they may also have some physiological value that relates to changes in the volume of fascial 'tubes'. Part I of this paper (Scarr, 2016) described a complex fascial network of collagen-reinforced tubular sheaths that are an integral part of muscle structure and function, and continuous with 'higher-level' fascial tubes surrounding groups of muscles, the limbs and entire body. The anisotropic arrangements of collagen fibres within the walls of these tubes reflect the most efficient distribution of mechanical stresses and have been considered to coordinate changes in shape, and a proposed link between cyclic variations in arterial pressure and volume, and the behaviour of these fascial compartments is now described.
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Affiliation(s)
- Graham Scarr
- 60 Edward Street Stapleford, Nottingham NG9 8FJ, UK.
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Scarr G. Fascial hierarchies and the relevance of crossed-helical arrangements of collagen to changes in the shape of muscles. J Bodyw Mov Ther 2015; 20:377-87. [PMID: 27210857 DOI: 10.1016/j.jbmt.2015.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 09/05/2015] [Accepted: 09/30/2015] [Indexed: 12/25/2022]
Abstract
Muscles are composite structures consisting of contractile myofibres surrounded by complex hierarchies of collagen-reinforced fascial sheaths. They are essentially flexible cylinders that change in shape, with the particular alignment of collagen fibres within their myofascial walls reflecting the most efficient distribution of mechanical stresses and coordinating these changes. However, while the functional significance of this crossed-helical fibre arrangement is well established in other species and in different parts of the body, relatively little attention has been given to this within the fascia of humans; and the relevance of this geometric configuration to muscles and surrounding fascial tissues is described.
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Affiliation(s)
- Graham Scarr
- 60 Edward Street, Stapleford, Nottingham, NG9 8FJ, UK.
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Huo J, Rojas R, Bohlin J, Hilborn J, Gamstedt EK. Parametric elastic analysis of coupled helical coils for tubular implant applications: Experimental characterization and numerical analysis. J Mech Behav Biomed Mater 2014; 29:462-9. [DOI: 10.1016/j.jmbbm.2013.09.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 09/24/2013] [Accepted: 09/26/2013] [Indexed: 10/26/2022]
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