Influence of Difference in Knee Alignment on Site of Pain and Psychological State after Long-Distance Walking
Languages of publication
Background and Study Aim: In this study, focusing on the individual difference in the characteristics of the knee joint, which plays an important role in weight bearing during walking, we examined the relationship between difference in knee alignment and pain in the legs during walking and effect of the pain on the psychological state of exercise performers. Material/Methods: A total of 40 subjects, including 25 healthy men and 15 women were recruited to this study. Knee alignment was classified according to the intercondylar and intermalleolar distances by increments of 2.0 cm. After walking (85km) on day 3 of the 5-day event, subjects were required to answer a questionnaire asking where in the leg they had pain. The psychological state of each subject was assessed by performing the Profile of Mood States (POMS) after they had rested after walking on each of days 1, 2 and 3 of the 5- day event. Results: The following sites exhibited significant differences in the number and incidence of injury between groups: the anterior side of lower leg (p <0.05), posterior side of lower leg (p <0.01), ankle joint (p <0.05) and sole of foot (p <0.01). In the genu valgum group, the score for factor V(:Vigor) decreased by 4.0 points between days 1 to 3: 18.1 ± 4.6 points on day 1 and 14.1 ± 7.6 points on day 3, with a significant difference between days 1 and 3. Conclusions: When performing an exercise that places load on the legs, such as walking, one should consider the risk of injury by measuring the individual’s knee alignment before commencing the exercise.
- 1. Hakim A.A., Curb J.D., Petrovitch H. et al :Effects of walking on coronary heart disease in elderly men: the Honolulu Heart Program. Circulation, 1999; 100: 9-13.
- 2. Lee I.M., Rexrode K.M., Cook N.R., Manson J.E. Buring J.E. : Physical activity and coronary heart disease in women: is "no pain, no gain" passé? JAMA : the journal of the American Medical Association, 2001; 285: 1447-54.
- 3. Manson J.E., Hu F.B., Rich-Edwards J.W. et al: A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease in women. The New England journal of medicine., 1999; 341: 650-8.
- 4. Wang G., Zheng Z.J., Heath G., Macera C., Pratt M., Buchner D.: Economic burden of cardiovascular disease associated with excess body weight in U.S. adults. American journal of preventive medicine , 2002; 23: 1-6.
- 5. Macera C.A., Jackson K.L., Hagenmaier G.W., Kronenfeld J.J., Kohl H.W., Blair S.N.: Age, physical activity, physical fitness, body composition, and incidence of orthopedic problems. Research quarterly for exercise and sport , 1989; 60: 225-33.
- 6. Simonsen E.B., Dyhre-Poulsen P., Voigt M., Aagaard P., Sjøgaard G.., Bojsen-Møller F. : Bone-onbone forces during loaded and unloaded walking. Acta anatomica , 1995; 152: 133-42.
- 7. Wluka A., Forbes A., Wang Y., Hanna F., Jones G., Cicuttini F.: Knee cartilage loss in symptomatic knee osteoarthritis over 4.5 years. Arthritis research & therapy, 2006; 8: R90.
- 8. Hurwitz D., Ryals A., Case J., Block J. and Andriacchi T. (2002) The knee adduction moment during gait in subjects with knee osteoarthritis is more closely correlated with static alignment than radiographic disease severity, toe out angle and pain, Journal of orthopaedic research 20, 101– 107.
- 9. Schipplein O.D. and Andriacchi T.P.: Interaction between active and passive knee stabilizers during level walking. Journal of orthopaedic research : official publication of the Orthopaedic Research Society , 1991; 9: 113-9.
- 10. Sogabe A., Mukai N., Shimojo H., et.al: A genu varum effects on each lower extremity muscle activity during leg press exercise. Japanese Journal of Physical Fitness and Sports Medicine, 2003; 52: 275-284.
- 11. Sogabe A., Mukai N., Shimojo H., et al: Genu varum effects on muscle hardness of lower limb after leg press exercise. The Journal of Japanese society of clinical sports medicine , 2003; 11: 518- 525.
- 12. Salis J.F., Hovell M.F., Hofstetter C.R., et al: Lifetime history of relapse from exercise. Addictive behaviors, 1990; 15: 573-579.
- 13. Weinberg R.S. and Gould D.: Exercise behavior and adherence. In Foundation of sport and exercise psychology. 2nd ed., Human kinetics, Champaign(IL), 1999.
- 14. Dishman R.K.: Compliance/ adherence in Health-rerated exercise. Health psychology , 1982; 1: 237-267.
- 15. Raglin J.S. and Wilson M.: State anxiety following 20 minutes of bicycle ergometer exercise at selected intensities. International journal of sports medicine, 1996; 17: 467-71.
- 16. Abraham W.M.: Factors in delayed muscle soreness. Medicine and science in sports, 1977; 9: 11- 20.
- 17. Armstrong R.B.: Mechanisms of exercise-induced delayed onset muscular soreness: a brief review. Medicine and science in sports and exercise, 1984; 16: 529-38.
- 18. Cleak M.J., Eston R.G.: Delayed onset muscle soreness: mechanisms and management. Journal of sports sciences, 1992; 10: 325-41.
- 19. Miles M.P., Clarkson P.M.: Exercise-induced muscle pain, soreness, and cramps. The Journal of sports medicine and physical fitness.,1994; 34: 203-16.
- 20. Kettelkamp D.B., Wenger D.R., Chao E.Y., Thompson C.: Results of proximal tibial osteotomy. The effects of tibiofemoral angle, stance-phase flexion-extension, and medial-plateau force. The Journal of bone and joint surgery. American volume, 1976; 58: 952-60.
- 21. Chao E.Y., Neluheni E.V., Hsu R.W., Paley D.: Biomechanics of malalignment. Orthop Clin North Am,1994; 25:379-386.
- 22. Hewett T.E., Lindenfeld T.N., Riccobene J.V., Noyes F.R.: The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study. The American journal of sports medicine, 1999; 27: 699-706.
- 23. Felson D.T., Zhang Y., Hannan M.T., et al: Risk factors for incident radiographic knee osteoarthritis in the elderly: the Framingham Study. Arthritis and rheumatism, 1997; 40:728-33.
- 24. Powers C.M., Maffucci R. and Hampton S.: Rearfoot posture in subjects with patellofemoral pain. The Journal of orthopaedic and sports physical therapy, 1995; 22: 155-60.
- 25. Mikulicz J.: Ueber individuelle Formdifferenzen am Femur und an der Tibia des Menschen. Mit Berucksichtigung de Statik des Kniegelenks. Arch Anat Entwicklungsgesch, 1878; 351.
- 26. Donald A.: Neumann Kinesiology of the Musculoskeletal System. Mosby Inc., St. Louis, 2002.
- 27. Williams T.J., Krahenbuhl G.S., Morgan D.W.: Mood state and running economy in moderately trained male runners. Medicine and science in sports and exercise, 1991; 23: 727-31.
- 28. Petruzzello S.J., Landers D.M., Hatfield B.D., Kubitz K.A., Salazar W.: A meta-analysis on the anxiety-reducing effects of acute and chronic exercise. Outcomes and mechanisms. Sports medicine, 1991; 11: 143-82.
Publication order reference