Journal of Paramedical Sciences & Rehabilitation

Journal of Paramedical Sciences & Rehabilitation

A Review on the Effects of Rehabilitation Exercises on the Mechanics of Movements Transfer in Individuals with Knee Valgus

Document Type : Review Article

Authors
A.H Hormati 1
E Piri 2
A.A Jafarnezhadgero 2
Z Hormati 3
S Imanibroj 2
1 Department of Sports Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
2 Department of Sports Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
3 MSc in Nursing Critical care
10.22038/jpsr.2025.74607.2542
Abstract
Purpose:
Knee valgus is a lower limb abnormality in which the knees incline inward. Therefore, the aim of this study was to investigate the effects of rehabilitation exercises and therapeutic interventions on the mechanics of transfer movements in individuals with knee valgus.
Methods:
For this review,  articles in both Persian and English languages were searched from April 2019 to June 2023 using the keywords Corrective exercises, Genu valgum, Knee Joint, Theraband and Rehabilitation exercises in Google Scholar, ISC, Scopus, PubMed, WOS, and SID databases. 98 articles were selected based on the inclusion and exclusion criteria. After removing duplicate articles and those that did not meet the selection criteria, 85 articles remained, of which 17 were finally selected for further detailed analysis.
Results:
Findings illustrated that the use of sports equipment such as braces and trabands can lead to the strengthening of lower limb muscles, stability and reduction of the injury rate in the knee joint during transitional movements. In addition, the results of corrective exercises indicated an increase in the strength of supporting muscles and tendons and improved knee joint rehabilitation during walking and landing. The simultaneous use effect of rehabilitation exercises and support tools showed a lower load on the joints of the lower limbs, especially the knee. Finally, investigating the biomechanical effects of transfer movements showed that excessive knee flexion and extension can lead to knee joint damage.
Conclusion:
It seems that the simultaneous effect of exercises aimed at knee joint rehabilitation and support tools could reduce the load on the joints of the lower limbs, reduce the injury rate and increase the strength of the supporting muscles of people with crossed knees.
Keywords
Genu valgum
Transitional movements
Corrective exercises
Rehabilitation exercises
  1. Jankowicz-Szymanska A, Mikolajczyk E. Genu valgum and flat feet in children with healthy and excessive body weight. Pediatr Phys Ther 2016; 28(2): 200-206.
  2. White GR, Mencio GA. Genu valgum in children: diagnostic and therapeutic alternatives. J Am Acad Orthop Surg 1995; 3(5): 275-283.
  3. Bahr R, Krosshaug T. Understanding injury mechanisms: a key component of preventing injuries in sport. Br J Sports Med 2005; 39(6): 324-329.
  4. Jafarnezhadgero A, Zivari M. Effect of Fatigue Protocol on Lower Limb Muscle Activities in Individuals with Genu Varus During Running with Agility Shoes1. Studies in Sport Medicine 2020; 12(28): 55-70.
  5. Van Gheluwe B, Kirby KA, Hagman F. Effects of simulated genu valgum and genu varum on ground reaction forces and subtalar joint function during gait. J Am Podiatr Med Assoc 2005; 95(6): 531-541.
  6. Piri E, Jafarnezhadgero A, Ebrahimpour H, Nasri A. Effect of Sports Training on Body Mechanics during Transitional Movements in Individuals with Foot Pronation: Literature from 2019-2022. JSSU 2023; 31 (4): 6544-6560.
  7. Mozafaripour E, Rajabi R, Minoonejad H. Anatomical Alignment of Lower Extremity in Subjects with Genu Valgum and Genu Varum Deformities. PTJ 2018; 8(1): 27-36.
  8. Shahidi-zandi Z, Amir-seyfaddini M-r, Amiri-Khorasani M-t. Evaluation of lower extremity kinematic characteristics during single-leg landing from different heights in patients with knee valgus deformity. The Scientific Journal of Rehabilitation Medicine 2017; 6(1): 122-131.
  9. Park H, Park M, Kim SM, Kim HW, Lee DH. Hemiepiphysiodesis for idiopathic genu valgum: percutaneous transphyseal screw versus tension-band plate. J Pediatr Orthop 2018; 38(6): 325-330.
  10. Shapiro G, Adato T, Paz S, Shrabaty T, et al. Hemiepiphysiodesis for coronal angular knee deformities: tension-band plate versus percutaneous transphyseal screw. Arch Orthop Trauma Surg 2022; 142(1): 105-113.
  11. Rabiei M, Jafarnejhad-Gre T, Binabaji H, Hosseininejad E, Anbarian M. Assessment of postural response after sudden perturbation in subjects with genu valgum. Journal of Shahrekord University of Medical Sciences 2012; 14(2): 90-100.
  12. Williams DS, McClay IS, Hamill J, Buchanan TS. Lower extremity kinematic and kinetic differences in runners with high and low arches. Journal of Applied Biomechanics 2001; 17(2): 153-163.
  13. Williams GN, Chmielewski T, Rudolph KS, Buchanan TS, Snyder-Mackler L. Dynamic knee stability: current theory and implications for clinicians and scientists. J orthop sports phys ther 2001; 31(10): 546-566.
  14. Farahpour N, Jafarnezhad A, Damavandi M, Bakhtiari A, Allard P. Gait ground reaction force characteristics of low back pain patients with pronated foot and able-bodied individuals with and without foot pronation. J Biomech 2016; 49(9): 1705-1710.
  15. Barghadi M, Shahbazioghli K, Piri E, Allahverdidost H, Nosrati Hashi A. Short-Term Effect Of Protective Knee Brace On Ankle And Knee Joint Co-Contractions In People With Genu Valgum During Jumping And Landing. Studies in Medical Sciences 2023; 34(2): 58-67.
  16. Mohammadi V, Letafatkar A, Sadeghi H, Jafarnezhadgero A, Hilfiker R. The effect of motor control training on kinetics variables of patients with non-specific low back pain and movement control impairment: Prospective observational study. J Bodyw Mov Ther 2017; 21(4): 1009-1016.
  17. Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health 1998; 52(6): 377-384.
  18. Valizadehorang A, Ghorbanlou F, Jafarnezhadgero AA. Effect of using graded knee brace at two angles of 60 and 30 degrees on the ground reaction forces components in individuals with genu valgum during landing. J Gorgan Univ Med Sci 2020; 22(2): 1-8.
  19. Sorkhe E, Jafarnezhadgero AA. Effect of a corrective exercise program on the frequency spectrum of ground reaction force during drop-landing in older adults with Genu Valgum. Iranian Journal of Ageing 2020; 14(4): 494-509.
  20. Gheitasi M, Bayattork M, Hovanloo F, Porrajab H. Comparing the effect of a fatigue protocol on kinematic gait parameters in students with genu valgum and genu varum and their normal peers PTJ. 2019; 9(2): 97-106.
  21. Ghorbanloo F, Jafarnezhadgero A, Alipour Sari Nasirloo M, Letafatkar A. The Effect of TheraBand Corrective Exercise on Co-contraction of Ankle Joint in Men with Genu Valgum during Walking: A Randomized Clinical Trial Study JRRS. 2019; 15(5): 249-255.
  22. Soltandoost-Nari SM, Shamsoddini A. Comparison of Functional Movement Screen Scores in Teenage Male Soccer Players with and without Genu Valgum and Genu Varum Deformities. Journal of Safety Promotion and Injury Prevention 2020; 8(3): 130-138.
  23. Gilani K, Mohammadipour F, Amirseyfaddini M. Comparison of maximum angles of knee varus and flexion in the stance phase of walking on a treadmill with different inclinations between female athletes with genu valgum and healthy knees. JRRS 2020; 16(1): 142-150.
  24. Agrawal AS, Phansopkar P. Impact of Intensive Physiotherapy on an Adolescent with Severe Genu Valgum Deformities: A Case Report. Cureus 2023; 15(1): e33907.
  25. Ghorbanlou F, Jafarnezhadgero AA. Effect of Corrective Exercise on Lower Limb Muscles’ Co-contraction in Males with Genu Valgum during Walking: A Clinical Trial Study. J Gorgan Univ Med Sci 2021; 23(4): 10-17.
  26. Ghorbanlou F, Jafarnezhadgero A, Fakhri Mirzanag E. The Effect of Training with Elastic Band on Electro Myography of Lower Limb Muscles in Genu Valgum Male Students during Running: A Clinical Trial Study JRUMS 2022; 21(3): 327-342.
  27. Jafarnezhadgero A, Ghorbanloo F, Fatollahi A, Dionisio VC, Granacher U. Effects of an elastic resistance band exercise program on kinetics and muscle activities during walking in young adults with genu valgus: A double-blinded randomized controlled trial. Clin Biomech 2021; 81: 105215.
  28. Ghorbanloo F, Jafarnezhadgero A, Fatollahi A. Investigating The Effect of 8 Weeks of Corrective Exercise with an Elastic Band on The Frequency Spectrum of Ground Reaction Forces in Young Boys with Genu Valgum During Running: A Randomized Clinical Trial Study. Studies in Medical Sciences 2021; 31(11): 893-881.
  29. Jafarnezhadgero A, Ghorbanloo F, Malekabadi AM, Ghasemi S. The acute effect of knee brace on the electromyography activity of lower limb muscles in individuals with genu valgus during walking. Med J Tabriz Uni Med Sci 2021; 43(1): 116-123.
  30. Jeon K, Ahn S, Jeong S-y. Biomechanical Analysis of the Knee Joint during Jump Landing of Genu Valgum Women. International Journal of Human Movement Science 2021; 15(2): 87-98.
  31. Jafarnezhadgero A, Abadi AMM, Yadegar A, Ghorbanloo F, Orang AV. The effect of graded knee brace at two angles of 60 and 30 degrees on the frequency spectrum of ground reaction forces in individuals with genu valgum during landing. Med J Tabriz Uni Med Sci 2021; 43(2): 220-229.
  32. Amiri MR, Golpayegani M, Moradi Vastgani F, Mirghasemi M. Effect of Proprioception Training on Pain and Knee Joint Position Sense of Athletes With Genuvalgum. J Sport Biomech 2020; 6(3): 170-179.
  33. Ghorbanloo F, Jafarnezhadgero A. The Effect of Corrective Exercises Using Thera-Band on Components of Ground Reaction Force in Boy Students with Genu Valgum during Running: A Clinical Trial Study. JRUMS 2020; 19(7): 661-676.
  34.  Li L, Landin D, Grodesky J, Myers J. The function of gastrocnemius as a knee flexor at selected knee and ankle angles. J Electromyogr Kinesiol 2002; 12(5): 385-390.
  35.  Nyland J, Smith S, Beickman K, Armsey, T, Caborn DN. Frontal plane knee angle affects dynamic postural control strategy during unilateral stance. Med Sci Sports Exerc,2002; 34(7): 1150-1157.
  36.  Robertson DGE, Caldwell GE, Hamill J, Kamen G, et al. Research methods in biomechanics: Human kinetics 2013; 441.
  37. Jafarnezhadgero AA, Noroozi Z, Piri E. Evaluating the Frequency of the Electrical Activity of Lower Limb Muscles before and after Fatigue during Running in Individuals with a History of Coronavirus Disease 2019 Compared to Healthy Individuals. Journal of Gorgan University of Medical Sciences 2024; 26(1): 56-65.‏‏‏
  38. Gribble PA, Hertel J, Denegar CR, Buckley WE. The effects of fatigue and chronic ankle instability on dynamic postural control. J Athl Train 2004; 39(4): 321-329.
  39. Mazidi M, Alizadeh MH, Rajabi R. The effects of one period of exercise therapy program on Q and popliteal angle in athlethes with Pattellofemoral pain syndrome. JRRS 2011; 7(2): 206-214.
  40. Vijayakumar K, Dineshkumar D. Effects of Therapeutic Weight Loss Exercises on Obese Indivduals with Genu Valgum Deformity Indian Journal of Public Health Research & Development. 2020; 11(9): 184-189.
Journal of Paramedical Sciences & Rehabilitation
Volume 14, Issue 1
Spring 2025
Pages 99-114