Efectos de un entrenamiento de fuerza y flexibilidad sobre el valgo de rodilla y dolor en mujeres jóvenes físicamente activas (Effects of strength and flexibility training on knee valgus and pain in adult women physically active adult women)

Autores/as

DOI:

https://doi.org/10.47197/retos.v61.107475

Palabras clave:

Terapia de ejercicio, articulación de la rodilla, síndrome de dolor patelofemoral, ejercicio físico, adultos jóvenes

Resumen

El valgo de rodilla es una alineación medial de la articulación que afecta principalmente a las mujeres. El objetivo de este estudio fue evaluar los efectos de un protocolo de entrenamiento de fuerza y flexibilidad sobre el valgo pasivo de rodilla (VPR), valgo dinámico de rodilla (VDR) y presencia de dolor en mujeres jóvenes físicamente activas. Treinta y cuatro mujeres universitarias, con edades entre 18 y 30 años, participaron en un programa de cuatro semanas de entrenamiento, que incluyó ejercicios con bandas elásticas (Therabands®). Las mediciones incluyeron el ángulo Q para VPR, la prueba de salto con aterrizaje (LESS) para VDR y la Escala Numérica Analógica (ENA) para la presencia de dolor. En los resultados: se encontró una disminución significativa en el VPR (p=0.0028), tamaño del efecto (d=0.20), con un cambio del -2.21%. En cuanto al VDR, se observaron reducciones significativas tanto en el primer aterrizaje (p<0.0001, d=0.34, cambio del -10.06%) como en el segundo aterrizaje (p=0.0226, d=0.13, cambio del -4,37%). La presencia de dolor también disminuyó significativamente (p=0.0019, d=0.89, cambio de -38.64%). Conclusión: Los resultados sugieren que un protocolo combinado de entrenamiento de fuerza y flexibilidad de cuatro semanas puede ser efectivo para reducir el VPR, VDR y el dolor en mujeres físicamente activas.

Palabras clave: Terapia de ejercicio; ejercicio físico; articulación de la rodilla; síndrome de dolor patelofemoral; adultos jóvenes.

Abstract. Introduction: Knee valgus is a medial alignment of the joint that primarily affects women. The objective of this study was to evaluate the effects of a strength and flexibility training protocol on passive knee valgus (PKV), dynamic knee valgus (DKV), and the presence of pain in physically active young women. Thirty-four college women, aged 18-30 years, participated in a four-week training program, which included exercises with TheraBand®. The measurements included the Q-angle for PKV, the Landing Escape Test (LESS) for DKV, and the Analog Numerical Scale (ENA) for the presence of pain. The results indicated a significant decrease in PKV (p=0.0028), effect size (d=0.20), with a change of -2.21%. About DKV, significant reductions were observed at both the initial and second landings. The first landing exhibited a p-value of less than 0.0001, with a d-value of 0.34, resulting in a 10.06% change. The second landing demonstrated a p-value of 0.0226, with a d-value of 0.13, resulting in a 4.37% change. Furthermore, the presence of pain was found to decrease significantly (p=0.0019, d=0.89, -38.64% change). It can be concluded that a four-week combined strength and flexibility training protocol may be effective in reducing PKV, DKV, and pain in physically active women.

Keywords: Exercise therapy; physical exercise; knee joint; patellofemoral pain syndrome; young adults.

Citas

Araújo, V. L., Souza, T. R., Carvalhais, V. O. do C., Cruz, A. C., & Fonseca, S. T. (2017). Effects of hip and trunk muscle strengthening on hip function and lower limb kinematics during step-down task. Clinical Biomechanics , 44, 28–35. https:/doi.org/10.1016/j.clinbiomech.2017.02.012

Bahadori, S., Fatahi, H., & Ahmadpoor, M. (2020). The Effect of TheraBand Training on the Q Angle and Distance of Ankle Medial Malleolus in Individuals With Genu Valgum Deformity. Physical Treatments-Specific Physical Therapy Journal, 10(3), 117-126. https:/doi.org/ 10.32598/ptj.10.3.304.3

Baldon, R. de M., Serrão, F. V., Scattone Silva, R., & Piva, S. R. (2014). Effects of functional stabilization training on pain, function, and lower extremity biomechanics in women with patellofemoral pain: a randomized clinical trial. The Journal of Orthopaedic and Sports Physical Therapy, 44(4), 240–251, A1–A8. https:/doi.org/10.2519/jospt.2014.4940

Bell, D. R., Oates, D. C., Clark, M. A., & Padua, D. A. (2013). Two- and 3-dimensional knee valgus are reduced after an exercise intervention in young adults with demonstrable valgus during squatting. Journal of Athletic Training, 48(4), 442–449. https:/doi.org/10.4085/1062-6050-48.3.16

Boling, M., Padua, D., Marshall, S., Guskiewicz, K., Pyne, S., & Beutler, A. (2010). Gender differences in the inci-dence and prevalence of patellofemoral pain syndrome. Scandinavian Journal of Medicine & Science in Sports, 20(5), 725–730. https:/doi.org/10.1111/j.1600-0838.2009.00996.x

Borg, G. A. (1982). Psychophysical bases of perceived exertion. Medicine and Science in Sports and Exercise, 14(5), 377–381. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/7154893

Cilengir, A. H., Cetinoglu, Y. K., Kazimoglu, C., Gelal, M. F., Mete, B. D., Elmali, F., & Tosun, O. (2021). The rela-tionship between patellar tilt and quadriceps patellar tendon angle with anatomical variations and pathologies of the knee joint. European Journal of Radiology, 139, 109719. https:/doi.org/10.1016/j.ejrad.2021.109719

Csintalan, R. P., Schulz, M. M., Woo, J., McMahon, P. J., & Lee, T. Q. (2002). Gender Differences in Patellofemo-ral Joint Biomechanics. Clinical Orthopaedics and Related Research, 402, 260. Retrieved from https://journals.lww.com/clinorthop/abstract/2002/09000/gender_differences_in_patellofemoral_joint.26.aspx

Collins, N., Barton, C., Middelkoop, M., Callaghan, M., Rathleff, M., Vicenzino, B., Davis, I., Powers, C., Macri, E., Hart, H., Silva, D., & Crossley, K. (2018). 2018 Consensus statement on exercise therapy and physical interven-tions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th Interna-tional Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017. British Journal of Sports Medicine, 52, 1170 - 1178. https://doi.org/10.1136/bjsports-2018-099397.

Dixit, S., Difiori, J. P., Burton, M., & Mines, B. (2007). Management of Patellofemoral Pain Syndrome. American Fam-ily Physician, 75(2), 194–202. Retrieved from https://www.aafp.org/pubs/afp/issues/2007/0115/p194.pdf

Ferber, R., Bolgla, L., Earl-Boehm, J. E., Emery, C., & Hamstra-Wright, K. (2015). Strengthening of the hip and core versus knee muscles for the treatment of patellofemoral pain: a multicenter randomized controlled trial. Journal of Athletic Training, 50(4), 366–377. https:/doi.org/10.4085/1062-6050-49.3.70

Ferreira-Valente, M. A., Pais-Ribeiro, J. L., & Jensen, M. P. (2011). Validity of four pain intensity rating scales. Pain, 152(10), 2399. https:/doi.org/10.1016/j.pain.2011.07.005

Ford, K. R., Myer, G. D., & Hewett, T. E. (2003). Valgus Knee Motion during Landing in High School Female and Male Basketball Players. Medicine & Science in Sports & Exercise, 35(10), 1745. https:/doi.org/10.1249/01.MSS.0000089346.85744.D9

Forman, D. A., Alizadeh, S., Button, D. C., & Holmes, M. W. (2023). The Use of Elastic Resistance Bands to Reduce Dynamic Knee Valgus in Squat-Based Movements: A Narrative Review. International journal of sports physical thera-py, 18(5), 1206–1217. https://doi.org/10.26603/001c.87764

Flores-Leon, A. F., Leyton Quezada, V. C., Martínez Hernández, M. J., Salazar Reinoso, D. A., & Berral de la Rosa, F. J. (2022). Efecto de la modificación del rango de movimiento del tobillo sobre el índice de valgo dinámico du-rante una sentadilla monopodal, en jugadoras de fútbol (Effect of ankle range of motion modification on dynamic valgus index during a monopodal squat in fema. Retos, 44, 952–959. https://doi.org/10.47197/retos.v44i0.91454

Ghulam, H. S. (2021). Effect of knee Valgus angle during single leg squat and horizontal hop for distance in patients with patellofemoral pain and controls. International Journal of Clinical Medicine, 12(06), 261–271. https:/doi.org/10.4236/ijcm.2021.126023

Gwynne, C. R., & Curran, S. A. (2018). Two-dimensional frontal plane projection angle can identify subgroups of patellofemoral pain patients who demonstrate dynamic knee valgus. Clinical Biomechanics , 58, 44–48. https:/doi.org/10.1016/j.clinbiomech.2018.06.021

Hewett, T. E., Myer, G. D., Ford, K. R., Heidt, R. S., Jr, Colosimo, A. J., McLean, S. G., … Succop, P. (2005). Bio-mechanical Measures of Neuromuscular Control and Valgus Loading of the Knee Predict Anterior Cruciate Liga-ment Injury Risk in Female Athletes: A Prospective Study. The American Journal of Sports Medicine. https:/doi.org/10.1177/0363546504269591

Ilahi, O. A., & Kohl, H. W., Iii. (1998). Lower Extremity Morphology and Alignment and Risk of Overuse Injury. Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine, 8(1), 38. Retrieved from https://journals.lww.com/cjsportsmed/abstract/1998/01000/lower_extremity_morphology_and_alignment_and_risk.9.aspx

Ismail, M. M., Gamaleldein, M. H., & Hassa, K. A. (2013). Closed kinetic chain exercises with or without additional hip strengthening exercises in management of patellofemoral pain syndrome: a randomized controlled trial. Euro-pean Journal of Physical and Rehabilitation Medicine, 49(5), 687–698. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23820880

Khasawneh, R. R., Allouh, M. Z., & Abu-El-Rub, E. (2019). Measurement of the quadriceps (Q) angle with respect to various body parameters in young Arab population. PloS One, 14(6), e0218387. https:/doi.org/10.1371/journal.pone.0218387

Larwa, J., Stoy, C., Chafetz, R. S., Boniello, M., & Franklin, C. (2021). Stiff Landings, Core Stability, and Dynamic Knee Valgus: A Systematic Review on Documented Anterior Cruciate Ligament Ruptures in Male and Female Ath-letes. International Journal of Environmental Research and Public Health, 18(7), 3826. https:/doi.org/10.3390/ijerph18073826

Lee, J., Lee, H., & Lee, W. (2014). Effect of Weight-bearing Therapeutic Exercise on the Q-angle and Muscle Activity Onset Times of Elite Athletes with Patellofemoral Pain Syndrome: A Randomized Controlled Trial. Journal of Phy-sical Therapy Science, 26(7), 989–992. https:/doi.org/10.1589/jpts.26.989

Madueño, A. F., De Hoyo Lora, M., Boza, S. R., Cortés, J. M., & Corrales, B. S. (2014). Varo y valgo de rodilla en cambios de dirección como factor de riesgo de lesión (Knee varus and valgus in sidecutting as injury risk factor). Re-tos, 26, 176–177. https:/doi.org/10.47197/retos.v0i26.34462

Mohammadi Nia Samakosh, H., Oliveira, R., Shahabi , S. ., Sarvarifar, B. ., Moddares Gorji, S. ., Amirkhanloo, A. ., Badicu, G., Hilal Yagin, F. ., & F. Alghannam, A. . (2024). Efectos del entrenamiento de alta intensidad y la esti-mulación eléctrica sobre el dolor, la discapaci-dad, la cinemática de la rodilla y el rendimiento en el dolor femoro-rrotuliano: un ensayo controlado aleatorio (Effects of High-intensity Training and Electrical Stimulation on Pain, Disability, Knee Kinematic and Performance in Patellofemoral Pain: A Randomized Controlled Trial). Retos, 55, 978–991. https://doi.org/10.47197/retos.v55.105913

Numata, H., Nakase, J., Kitaoka, K., Shima, Y., Oshima, T., Takata, Y., … Tsuchiya, H. (2017). Two-dimensional motion analysis of dynamic knee valgus identifies female high school athletes at risk of non-contact anterior cruci-ate ligament injury. Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA, 26(2), 442–447. https:/doi.org/10.1007/s00167-017-4681-9

Organización Panamericana de la Salud. (9 de mayo de 2012). Recomendaciones mundiales sobre actividad física para la salud. https://www.paho.org/es/noticias/9-5-2012-recomendaciones-mundiales-sobre-actividad-fisica-para-salud

Padua, D. A., Marshall, S. W., Boling, M. C., Thigpen, C. A., Garrett, W. E., Jr, & Beutler, A. I. (2009). The Landing Error Scoring System (LESS) Is a valid and reliable clinical assessment tool of jump-landing biomechanics: The JUMP-ACL study. The American Journal of Sports Medicine, 37(10), 1996–2002. https:/doi.org/10.1177/0363546509343200

Peeler, J., & Anderson, J. E. (2007). Effectiveness of static quadriceps stretching in individuals with patellofemoral joint pain. Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine, 17(4), 234–241. https:/doi.org/10.1097/JSM.0b013e3180f60afc

Powers, C. M. (2010). The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. The Journal of Orthopaedic and Sports Physical Therapy, 40(2), 42–51. https:/doi.org/10.2519/jospt.2010.3337

Puddu, G., Cipolla, M., Cerullo, G., Franco, V., & Giannì, E. (2009). Which osteotomy for a valgus knee? Interna-tional Orthopaedics, 34(2), 239–247. https:/doi.org/10.1007/s00264-009-0820-3

Russell, K. A., Palmieri, R. M., Zinder, S. M., & Ingersoll, C. D. (2006). Sex differences in valgus knee angle during a single-leg drop jump. Journal of Athletic Training, 41(2), 166–171. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16791301

Saad, M. C., Vasconcelos, R. A. de, Mancinelli, L. V. de O., Munno, M. S. de B., Liporaci, R. F., & Grossi, D. B. (2018). Is hip strengthening the best treatment option for females with patellofemoral pain? A randomized con-trolled trial of three different types of exercises. Brazilian Journal of Physical Therapy, 22(5), 408–416. https:/doi.org/10.1016/j.bjpt.2018.03.009

Sahabuddin, F. N. A., Jamaludin, N. I., Amir, N. H., & Shaharudin, S. (2021). The effects of hip- and ankle-focused exercise intervention on dynamic knee valgus: a systematic review. PeerJ, 9, e11731. https:/doi.org/10.7717/peerj.11731

Samaei, A., Bakhtiary, A. H., Elham, F., & Rezasoltani, A. (2012). Effects of genu varum deformity on postural stabil-ity. International Journal of Sports Medicine, 33(6), 469–473. https:/doi.org/10.1055/s-0031-1301331

Santos, J. D. M. dos, Oliveira, M. A. de, Silveira, N. J. F. da, Carvalho, S. de S., & Oliveira, A. G. (2011). Confiabilidade inter e intraexaminadores nas mensurações angulares por fotogrametria digital e goniometria. Fisioterapia em Movimento, 24(3), 389–400. https:/doi.org/10.1590/S0103-51502011000300003

Silva, D. de O., Briani, R. V., Pazzinatto, M. F., Gonçalves, A. V., Ferrari, D., Aragão, F. A., & de Azevedo, F. M. (2015). Q-angle static or dynamic measurements, which is the best choice for patellofemoral pain? Clinical Biome-chanics , 30(10), 1083–1087. https:/doi.org/10.1016/j.clinbiomech.2015.09.002

Skouras, A. Z., Kanellopoulos, A. K., Stasi, S., Triantafyllou, A., Koulouvaris, P., Papagiannis, G., & Papathanasiou, G. (2022). Clinical Significance of the Static and Dynamic Q-angle. Cureus, 14(5), e24911. https:/doi.org/10.7759/cureus.24911

Støve, M. P., Hirata, R. P., & Palsson, T. S. (2021). The tolerance to stretch is linked with endogenous modulation of pain. Scandinavian Journal of Pain, 21(2), 355–363. https:/doi.org/10.1515/sjpain-2020-0010

Tyler, T. F., Nicholas, S. J., Mullaney, M. J., & McHugh, M. P. (2006). The Role of Hip Muscle Function in the Treatment of Patellofemoral Pain Syndrome. The American Journal of Sports Medicine. https:/doi.org/10.1177/0363546505281808

Wilczyński, B., Wąż, P., & Zorena, K. (2021). Impact of Three Strengthening Exercises on Dynamic Knee Valgus and Balance with Poor Knee Control among Young Football Players: A Randomized Controlled Trial. HealthcarePapers, 9(5), 558. https:/doi.org/10.3390/healthcare9050558

Wilczyński, B., Zorena, K., & Ślęzak, D. (2020). Dynamic Knee Valgus in Single-Leg Movement Tasks. Potentially Modifiable Factors and Exercise Training Options. A Literature Review. International Journal of Environmental Re-search and Public Health, 17(21), 8208. https:/doi.org/10.3390/ijerph17218208

Witvrouw, E., Callaghan, M. J., Stefanik, J. J., Noehren, B., Bazett-Jones, D. M., Willson, J. D., … Crossley, K. M. (2014). Patellofemoral pain: consensus statement from the 3rd International Patellofemoral Pain Research Retreat held in Vancouver, September 2013. British Journal of Sports Medicine, 48(6), 411–414. https:/doi.org/10.1136/bjsports-2014-093450

Fick, C. N., Jiménez-Silva, R., Sheehan, F. T., & Grant, C. (2022). Patellofemoral kinematics in patellofemoral pain syndrome: The influence of demographic factors. Journal of biomechanics, 130, 110819. https://doi.org/10.1016/j.jbiomech.2021.110819

Descargas

Publicado

2024-10-02

Cómo citar

Astorga Verdugo, S. ., González silva, S., Martínez Araya, A., Concha-Cisternas, Y., Luna-Villouta, P. ., Alarcón-Rivera, M. ., & Fuentes-Barría, H. (2024). Efectos de un entrenamiento de fuerza y flexibilidad sobre el valgo de rodilla y dolor en mujeres jóvenes físicamente activas (Effects of strength and flexibility training on knee valgus and pain in adult women physically active adult women). Retos, 61, 260–266. https://doi.org/10.47197/retos.v61.107475

Número

Sección

Artículos de carácter científico: trabajos de investigaciones básicas y/o aplicadas

Artículos más leídos del mismo autor/a

1 2 3 > >>