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Rehabilitation improves walking kinematics in children with a knee varus: randomized controlled trial
Jafarnezhadgero AA, Majlesi M, Etemadi H, Robertson DGE
Annals of Physical and Rehabilitation Medicine 2018 May;61(3):125-134
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Previous studies have demonstrated increased medial stresses in knee varus alignment. Selecting a suitable treatment strategy for individuals with knee malalignment should be a priority. OBJECTIVES: We aimed to investigate the effects of a 16-week corrective exercise continuum (CEC) program on 3-D joint angles of the dominant and non-dominant lower limbs in children with genu varus during walking. METHODS: Overall, 28 male children with genu varus (age range 9 to 14 years) volunteered to participate in this study. They were randomly divided into 2 equal groups (experimental and control). The participants of the experimental group received CEC for 16 weeks. 3-D gait analysis involved using a Vicon Motion System. Paired and independent sample t-tests were used for within- and between-group comparisons, respectively. RESULTS: For the experimental group, comparison of pre- and post-test joint kinematics of the dominant lower limb revealed that CEC decreased the peak ankle dorsiflexion angle by 26% (p = 0.020), peak foot internal rotation angle by 53% (p = 0.001), peak knee internal rotation angle by 40% (p = 0.011), peak hip abduction by 47% (p = 0.010), and peak hip external rotation angle by 60% (p = 0.001). In contrast, peak knee external rotation angle of the dominant limb was increased after the training program by 46% (p = 0.044). For the non-dominant lower limb, CEC decreased the peak ankle inversion by 63% (p < 0.01), peak ankle eversion by 91% (p < 0.01), peak foot internal rotation by 50% (p < 0.01), peak knee internal rotation by 29%; p = 0.042), peak hip abduction angle by 38% (p < 0.01), and peak hip external rotation angle by 60% (p < 0.01). CONCLUSIONS: CEC therapy reduced excessive foot and knee internal rotations as well as excessive hip external rotation during walking in children with genu varus.

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