Two- and 3-Dimensional Knee Valgus Are Reduced After an Exercise Intervention in Young Adults With Demonstrable Valgus During Squatting

Abstract

Context: Two-dimensional (or medial knee displacement [MKD]) and 3-dimensional (3D) knee valgus are theorized to contribute to anterior cruciate ligament injuries. However, whether these displacements can be improved in the double-legged squat (DLS) after an exercise intervention is unclear. Objective: To determine if MKD and 3D knee valgus are improved in a DLS after an exercise intervention. Design:  Randomized controlled clinical trial. Setting: Research laboratory. Patients or Other Participants: A total of 32 participants were enrolled in this study and were randomly assigned to the control (n = 16) or intervention (n = 16) group. During a DLS, all participants demonstrated knee valgus that was corrected with a heel lift. Intervention(s):  The intervention group completed 10 sessions of directed exercise that focused on hip and ankle strength and flexibility over a 2- to 3-week period. Main Outcome Measure(s): We assessed MKD and 3D knee valgus during the DLS using an electromagnetic tracking system. Hip strength and ankle-dorsiflexion range of motion were measured. Change scores were calculated for MKD and 3D valgus at 0%, 10%, 20%, 30%, 40%, and 50% phases, and group (2 levels)-by phase (6 levels) repeated-measures analyses of variance were conducted. Independent t tests were used to compare change scores in other variables (α < .05). Results: The MKD decreased from 20% to 50% of the DLS (P = .02) and 3D knee valgus improved from 30% to 50% of the squat phase (P = .001). Ankle-dorsiflexion range of motion (knee extended) increased in the intervention group (P = .009). No other significant findings were observed (P > .05). Conclusions:  The intervention reduced MKD and 3D knee valgus during a DLS. The intervention also increased ankle range of motion. Our inclusion criteria might have limited our ability to observe changes in hip strength.