Effect of Combined Exercise Program on Lower Extremity Alignment and Knee Pain in Patients with Genu Varum

Abstract

This study aimed to assess the effect of a combined exercise program on lower-extremity alignment and knee pain in patients with genu varum. Forty-seven middle-aged women with knee pain and genu varum were randomly divided into the exercise (EG, n = 24) and control (CG, n = 23) groups. The exercise group underwent a combined exercise program lasting 60 min in one session, three times a week for 12 weeks. Knee-to-knee length (KTKL), hip-knee-ankle angle (HKAA), hip inclination angle (HIA), and medial proximal tibial angle (MPTA) were assessed to evaluate lower-extremity alignment. To evaluate knee pain, the short form-McGill Pain Questionnaire (SF-MPQ) were used. There was a significant difference between the groups, and a decrease of 16% in KTKL (from 6.48 ± 1.26 cm to 5.47 ± 1.21 cm) was shown in EG. Other variables, including HKAA, HIA, and MPTA on the right side, showed significant differences between pre- and post-intervention in EG (p < 0.01, p < 0.01, and p < 0.01, respectively). SF-MPQ score improved with 45% from 18.75 ± 1.64 to 10.33 ± 2.47 after exercise intervention in EG. These results suggest that the combined exercise program, including strength and neuromuscular exercises, is an effective intervention for improving lower-extremity alignment and knee pain in middle-aged women with genu varum.

Keywords: combined exercise; genu varum; hip inclination angle; hip–knee–ankle angle; knee pain; knee to knee length; lower extremity; middle-aged women.

Figure 1

A flowchart of this study.

Figure 2

Measurement of lower extremity alignment: (A) measurement of hip–knee–ankle angle; (B) measurement of hip inclination angle; (C) measurement of medial proximal tibia angle.

Figure 3

Values are presented as the mean ± standard deviation: (A) knee-to-knee length (KTKL); (B) hip–knee–ankle angle (Left); (C) hip–knee–ankle angle (Right); (D) hip inclination angle (Left); (E) hip inclination angle (Right); (F) medial proximal tibial angle (Left); (G) medial proximal tibial angle (Right); (H) short form-McGill Pain Questionnaire (SF-MPQ). Significant differences using paired t-test: *** p < 0.001. Significant differences using independent t-test: †† p < 0.01, ††† p < 0.001.