Li W-J1,2, Lin YM1,3, Huang BR1,4, Lin Y-H1,5,6
1Chang Gung University, School of Physical Therapy and Graduate Institute of Rehabilitation Science, Taoyuan, Taiwan, 2Taiwan Adventist Hospital, Health Checkup Center, Taipei, Taiwan, 3Xin Tai General Hospital, Physical Therapy, New Taipei City, Taiwan, 4Landseeds Hospital, Division of Physical Therapy, Department of Rehabilitation and Physical Medicine, Taoyuan, Taiwan, 5Chang Gung University, Healthy Aging Research Center, Taoyuan, Taiwan, 6Chiayi Chang GungMemorial Hosipital, Physical Medicine and Rehabilitation, Chiayi, Puzi, Taiwan
Background: Overweight is recognized as a major problem of public health and as a risk factor for diseases such as musculoskeletal system disorders that develops malalignment of the lower-extremities like the knee deformities. While, it's rare to explore the issues related to the knee alignment during squatting activities in overweight individuals.
Purpose: We aimed to investigate the knee alignment by using photographic images during squatting activities in overweight adults.
Methods: We recruited volunteers aged between 23 to 50 years with BMI≥ 24. We measured the knee alignment including Q-angle in supine position for the patellofemoral joint and front plane projection angle between the femoral axis and the tibial axis (T-F Angle) while standing as well as squatting with both double stance and single stance. We took photographs of the knee alignment and calculated for the knee joint angle using software (Shekel Scale ID Ver: 3.0.7). Depending on the results of Shapiro-Wilk test, statistical analyses was done with the independent t-test or Mann-Whitney U t-test to determine whether there is a statistically significant difference in the measures of the knee alignment between male and female participants as well as the difference between dominant leg and non- dominant leg while squatting. Spearman´s rank correlation coefficient was calculated for determining the association between BMI and measures of knee alignment in participants.
Results: We recruited 18 overweight volunteers (10F/8M) with mean age 34.4±7.5 years and mean BMI 29.9±5.4 kg/ m2.The results revealed that Q angle was larger than normal value (16.3±5.7°) and T-F anglebecame larger close to be genu varum with one leg stance from standing to squatting down (-4.6±3.5°to 8.2±10.5°). There was no significant difference in measures of the knee alignment during squatting between sex or leg dominance. However, BMI was significantly correlated with Q-angle (r=0.552, p=0.02) as well as T-F angle of non-dominant side on single stance standing (r=-0.606, p=0.01) and during single stance squatting (r=-0.554, p=0.02). In addition, the male overweight participants demonstrated that their BMI was significantly correlated with the T-F angle of non-dominant side measured on single stance standing (r=-0.883, p= 0.01).While, thefemales with overweight demonstrated that BMI was significant correlated with Q-angle (r=0.644, p=0.04) as well as T-F angle of non-dominant side on single stance standing and during squatting (r=-0.648, p=0.04).
Conclusion(s): We conclude that the knee alignment of nondominant side on single stance standing and during squatting is associated with BMI. The angle between the femur and the tibia during single stance would close to the genu varum in overweight adults with higher BMI. Moreover, the female overweight adults with higher BMI may have more Q-angle of the non-dominant leg indicating the patellofemoral malalignment as well as less T-F angle related with genu varum during single stance squatting.
Implications: The results of our study suggest clinicians the relationship between the BMI and the knee alignment in overweight adults during squatting as a reference for screening the knee problems. Moreover, control of body weight could be the recommendation as protection of degenerative deterioration of the knee joint during functional activity such as squatting.
Keywords: Overweight, knee alignment, squatting
Funding acknowledgements: The present work was supported by the Taiwan Adventist Hospital, Taipei, Taiwan.
Purpose: We aimed to investigate the knee alignment by using photographic images during squatting activities in overweight adults.
Methods: We recruited volunteers aged between 23 to 50 years with BMI≥ 24. We measured the knee alignment including Q-angle in supine position for the patellofemoral joint and front plane projection angle between the femoral axis and the tibial axis (T-F Angle) while standing as well as squatting with both double stance and single stance. We took photographs of the knee alignment and calculated for the knee joint angle using software (Shekel Scale ID Ver: 3.0.7). Depending on the results of Shapiro-Wilk test, statistical analyses was done with the independent t-test or Mann-Whitney U t-test to determine whether there is a statistically significant difference in the measures of the knee alignment between male and female participants as well as the difference between dominant leg and non- dominant leg while squatting. Spearman´s rank correlation coefficient was calculated for determining the association between BMI and measures of knee alignment in participants.
Results: We recruited 18 overweight volunteers (10F/8M) with mean age 34.4±7.5 years and mean BMI 29.9±5.4 kg/ m2.The results revealed that Q angle was larger than normal value (16.3±5.7°) and T-F anglebecame larger close to be genu varum with one leg stance from standing to squatting down (-4.6±3.5°to 8.2±10.5°). There was no significant difference in measures of the knee alignment during squatting between sex or leg dominance. However, BMI was significantly correlated with Q-angle (r=0.552, p=0.02) as well as T-F angle of non-dominant side on single stance standing (r=-0.606, p=0.01) and during single stance squatting (r=-0.554, p=0.02). In addition, the male overweight participants demonstrated that their BMI was significantly correlated with the T-F angle of non-dominant side measured on single stance standing (r=-0.883, p= 0.01).While, thefemales with overweight demonstrated that BMI was significant correlated with Q-angle (r=0.644, p=0.04) as well as T-F angle of non-dominant side on single stance standing and during squatting (r=-0.648, p=0.04).
Conclusion(s): We conclude that the knee alignment of nondominant side on single stance standing and during squatting is associated with BMI. The angle between the femur and the tibia during single stance would close to the genu varum in overweight adults with higher BMI. Moreover, the female overweight adults with higher BMI may have more Q-angle of the non-dominant leg indicating the patellofemoral malalignment as well as less T-F angle related with genu varum during single stance squatting.
Implications: The results of our study suggest clinicians the relationship between the BMI and the knee alignment in overweight adults during squatting as a reference for screening the knee problems. Moreover, control of body weight could be the recommendation as protection of degenerative deterioration of the knee joint during functional activity such as squatting.
Keywords: Overweight, knee alignment, squatting
Funding acknowledgements: The present work was supported by the Taiwan Adventist Hospital, Taipei, Taiwan.
Topic: Musculoskeletal: lower limb
Ethics approval required: No
Institution: Taiwan Adventist Hospital
Ethics committee: Taiwan Adventist Hospital
Reason not required: This is the pilot study for our future study.
All authors, affiliations and abstracts have been published as submitted.
