Volume 9, Issue 4 (3-2024)
J Sport Biomech 2024, 9(4): 352-368 |
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Barghamadi M, Ghadimi KheshtMasjedi A, Piri E. Comparison of the Effect between Traband and Brace on People with Genu Varum and Genu Valgum Deformities: A Systematic Review. J Sport Biomech 2024; 9 (4) :352-368
URL: http://biomechanics.iauh.ac.ir/article-1-334-en.html
URL: http://biomechanics.iauh.ac.ir/article-1-334-en.html
1- Department of Sport Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
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Extended Abstract
1. Introduction
Abnormalities in the lower limbs can profoundly impact the biomechanics of human movements, such as walking, often resulting in symptoms of joint instability (1). Complications in the knee and ankle regions heighten the risk of injury among individuals, as these areas serve as crucial points of contact between the body and the ground (2). Genu varum and genu valgum represent common lower limb abnormalities (3), with these mechanical alterations also exerting adverse effects on the surrounding ankle muscles' activity (4). Genu varum, a frontal plane knee abnormality, is particularly prevalent among athletes (6). Several studies have identified genu varum as a risk factor for conditions like patellofemoral pain syndrome and as a predictive element in knee joint ligament injuries, including anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) injuries (9).
Traband emerges as a notable corrective tool utilized in addressing crossed knees and braces. Studies have demonstrated Traband's efficacy in enhancing strength, mobility, and performance while alleviating joint pain associated with various deformities, including pronitis. Consequently, this study aims to investigate the utilization of Traband and braces within diverse training protocols for individuals diagnosed with genu varum and genu valgum.
2. Methods
The present study was conducted as a systematic review, focusing on articles written in Persian from 2018 to 2024. These articles were sourced from specialized databases including Wos, ScienceDirect, Sid, Magiran, Civilica, Isc, PubMed, Scopus, and Google Scholar. The search utilized keywords such as Theraband, brace, crossed knee, bracket knee, and corrective exercises. Initially, thirty-seven articles were identified based on predetermined inclusion and exclusion criteria.
After screening, ten articles were selected for analysis, specifically investigating the impact of various exercise protocols involving Theraband and braces on genu varum and genu valgum injuries. The quality assessment of these selected articles was conducted using the Downs and Black questionnaire (14).
3. Results
In the current study, thirty-seven articles were retrieved through keyword searches, of which 10 met the inclusion criteria and underwent analysis. Among these, the review of 3 articles focusing on the improvement of genu valgum deformity indicated that training protocols utilizing Theraband led to increased strength in knee muscles. Furthermore, enhancements in kinetic, proprioceptive, and knee function variables were observed, resulting in a positive effect on addressing this anomaly. Additionally, the review of 2 articles concerning training protocols utilizing Theraband demonstrated its significant impact on improving genu varum deformity, showing positive outcomes in rectifying this deformity.
Regarding exercise protocols utilizing braces, the review of 3 articles revealed that such exercises contributed to the restoration of muscle strength and improvements in sensory depth and balance. These exercises played a pivotal role in addressing genu valgum deformity. Moreover, the review of 2 articles highlighted that the inclusion of braces in various training protocols enhanced individual performance and mitigated cruciate ligament deformities.
The findings from these articles are summarized in Table 3. Evaluation of the articles was conducted using the Downs and Black questionnaire, revealing a total average quality score of 76.44%. Notably, the lowest quality articles scored 64.51%, while the highest quality articles scored 90.32%.
Abnormalities in the lower limbs can profoundly impact the biomechanics of human movements, such as walking, often resulting in symptoms of joint instability (1). Complications in the knee and ankle regions heighten the risk of injury among individuals, as these areas serve as crucial points of contact between the body and the ground (2). Genu varum and genu valgum represent common lower limb abnormalities (3), with these mechanical alterations also exerting adverse effects on the surrounding ankle muscles' activity (4). Genu varum, a frontal plane knee abnormality, is particularly prevalent among athletes (6). Several studies have identified genu varum as a risk factor for conditions like patellofemoral pain syndrome and as a predictive element in knee joint ligament injuries, including anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) injuries (9).
Traband emerges as a notable corrective tool utilized in addressing crossed knees and braces. Studies have demonstrated Traband's efficacy in enhancing strength, mobility, and performance while alleviating joint pain associated with various deformities, including pronitis. Consequently, this study aims to investigate the utilization of Traband and braces within diverse training protocols for individuals diagnosed with genu varum and genu valgum.
2. Methods
The present study was conducted as a systematic review, focusing on articles written in Persian from 2018 to 2024. These articles were sourced from specialized databases including Wos, ScienceDirect, Sid, Magiran, Civilica, Isc, PubMed, Scopus, and Google Scholar. The search utilized keywords such as Theraband, brace, crossed knee, bracket knee, and corrective exercises. Initially, thirty-seven articles were identified based on predetermined inclusion and exclusion criteria.
After screening, ten articles were selected for analysis, specifically investigating the impact of various exercise protocols involving Theraband and braces on genu varum and genu valgum injuries. The quality assessment of these selected articles was conducted using the Downs and Black questionnaire (14).
3. Results
In the current study, thirty-seven articles were retrieved through keyword searches, of which 10 met the inclusion criteria and underwent analysis. Among these, the review of 3 articles focusing on the improvement of genu valgum deformity indicated that training protocols utilizing Theraband led to increased strength in knee muscles. Furthermore, enhancements in kinetic, proprioceptive, and knee function variables were observed, resulting in a positive effect on addressing this anomaly. Additionally, the review of 2 articles concerning training protocols utilizing Theraband demonstrated its significant impact on improving genu varum deformity, showing positive outcomes in rectifying this deformity.
Regarding exercise protocols utilizing braces, the review of 3 articles revealed that such exercises contributed to the restoration of muscle strength and improvements in sensory depth and balance. These exercises played a pivotal role in addressing genu valgum deformity. Moreover, the review of 2 articles highlighted that the inclusion of braces in various training protocols enhanced individual performance and mitigated cruciate ligament deformities.
The findings from these articles are summarized in Table 3. Evaluation of the articles was conducted using the Downs and Black questionnaire, revealing a total average quality score of 76.44%. Notably, the lowest quality articles scored 64.51%, while the highest quality articles scored 90.32%.
Table 3. Evaluation of the quality of the reviewed articles by Downs and Black questionnaire
| Valizadehorang & et al. (24) | Jafarnezhadgero & et al. (23) | Naghdizadeh & et al. (22) | Norinasab & et al. (21) | Barghadi & et al. (20) | Bahadori & et al. (19) | Ghasemi & et al. (18) | Ghorbanlo & et al. (17) | Ghorbanlo & et al. (16) | Jafarzadeh & et al. (15) | |
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | Is the hypothesis/aim/objective of the study clearly described? |
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | Are the main outcomes to be measured clearly described in the Introduction or Methods Section? |
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | Are the characteristics of the patients included in the study clearly described? |
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | Are the interventions of interest clearly described? |
| 0 | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 0 | 0 | Are the distributions of principal confounders in each group of subjects to be compared clearly described? |
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | Are the main findings of the study clearly described? |
| 0 | 0 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | Does the study provide estimates of the random variability in the data for the main outcomes? |
| 1 | 0 | 0 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | Have all important adverse events that may be a consequence of the intervention been reported? |
| 1 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | Have the characteristics of patients lost to follow-up been described? |
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | Have actual probability values been reported? |
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | Were the subjects asked to participate in the study representative of the entire population from which they were recruited? |
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | Were those subjects who were prepared to participate representative of the entire population from which they were recruited? |
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | Were the staff, places, and facilities where the patients were treated, representative of the treatment the majority of patients receive? |
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | Was an attempt made to blind study subjects to the intervention they have received ? |
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | Was an attempt made to blind those measuring the main outcomes of the intervention? |
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | If any of the results of the study were based on “data dredging”, was this made clear? |
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | In trials and cohort studies, do the analyses adjust for different lengths of follow-up of patients, or in case-control studies, is the time period between the intervention and outcome the same for cases and controls ? |
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | Were the statistical tests used to assess the main outcomes appropriate? |
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | Was compliance with the intervention/s reliable? |
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | Were the main outcome measures used accurate? |
| 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 1 | Were the patients in different intervention groups or were the cases and controls recruited from the same population? |
| 0 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | Were study subjects in different intervention groups or were the cases and controls recruited over the same period of time? |
| 1 | 0 | 1 | 0 | 0 | 1 | 1 | 0 | 0 | 1 | Were study subjects randomised to intervention groups? |
| 1 | 0 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 1 | Was the randomised intervention assignment concealed from both patients and health care staff until recruitment was complete and irrevocable? |
| 0 | 0 | 0 | 1 | 0 | 1 | 1 | 1 | 0 | 0 | Was there adequate adjustment for confounding in the analyses from which the main findings were drawn? |
| 0 | 0 | 0 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | Were losses of patients to follow-up taken into account? |
| 4 | 3 | 4 | 5 | 4 | 5 | 4 | 3 | 3 | 3 | Did the study have sufficient power to detect a clinically important effect where the probability value for a difference being due to chance is less than 5%? |
4. Conclusion
The aim of the present study is to investigate the effectiveness of using Traband and braces within various training protocols for individuals with genu varum and genu valgum. Alterations such as increasing valgus or crossing of the knee can disrupt the natural alignment of the lower limb, potentially compromising balance control (25). Moreover, changes in lower limb angles are common non-traumatic complications that tend to progress, making posture control challenging (26). Accompanying deformities in the hip and ankle joints, biomechanical alterations, and shifts in muscle tension due to changes in body alignment can exacerbate the strain on ligaments around the knee, impacting muscle function in individuals with these deformities (27). The study's findings suggest that different exercises utilizing braces and Trabands are effective in addressing knee brace and crossed knee deformities. However, Traband offers the advantage of not restricting movement and being more cost-effective compared to braces.
Ethical Considerations
Compliance with ethical guidelines
There were no ethical considerations to be addressed in this research.
Funding
This research did not receive any grants from funding agencies in the public, commercial, or non-profit sectors.
Authors' contributions
All authors contributed equally to preparing the article.
Conflicts of interest
The authors declared no conflict of interest.
The aim of the present study is to investigate the effectiveness of using Traband and braces within various training protocols for individuals with genu varum and genu valgum. Alterations such as increasing valgus or crossing of the knee can disrupt the natural alignment of the lower limb, potentially compromising balance control (25). Moreover, changes in lower limb angles are common non-traumatic complications that tend to progress, making posture control challenging (26). Accompanying deformities in the hip and ankle joints, biomechanical alterations, and shifts in muscle tension due to changes in body alignment can exacerbate the strain on ligaments around the knee, impacting muscle function in individuals with these deformities (27). The study's findings suggest that different exercises utilizing braces and Trabands are effective in addressing knee brace and crossed knee deformities. However, Traband offers the advantage of not restricting movement and being more cost-effective compared to braces.
Ethical Considerations
Compliance with ethical guidelines
There were no ethical considerations to be addressed in this research.
Funding
This research did not receive any grants from funding agencies in the public, commercial, or non-profit sectors.
Authors' contributions
All authors contributed equally to preparing the article.
Conflicts of interest
The authors declared no conflict of interest.
Type of Study: case report |
Subject:
Special
Received: 2024/05/15 | Accepted: 2024/05/23 | Published: 2024/05/23
Received: 2024/05/15 | Accepted: 2024/05/23 | Published: 2024/05/23
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