THE RELATIONSHIP BETWEEN HIP MUSCLE STRENGTH AND DYNAMIC KNEE VALGUS IN ASYMPTOMATIC FEMALES: A SYSTEMATIC REVIEW

BACKGROUND & OBJECTIVE

Lower extremity valgus during dynamic activities has been related both prospectively and retrospectively to lower extremity injuries such as patellofemoral pain and anterior cruciate ligament injuries. One of the common clinical beliefs is that hip muscle weakness is related to this specific biomechanical pattern. A previous systematic review in 2012 found limited evidence for a relationship between hip muscle strength and dynamic lower extremity valgus in males and females. However, new studies have been published since 2012, and the influence of the strength and task measures was not known.

The aim of this systematic review was to summarize current evidence investigating the relationship between hip muscle strength and dynamic lower extremity valgus during dynamic tasks among asymptomatic females. Secondly, this study aimed to investigate whether the relationship between hip muscle strength and dynamic lower extremity valgus was dependent on the strength measures or tasks being assessed.

METHODS

Four electronic databases were systematically searched. Peer-reviewed studies were included if they investigated the relationship between hip muscle strength and dynamic knee or lower extremity valgus in healthy females above 18 years of age. Hip muscle strength measures were defined as isometric, isokinetic or isotonic strength measures using reliable methods. Biomechanical measures included 3D measures of kinematics related to dynamic lower extremity valgus (i.e. any combination of hip adduction/internal rotation, knee abduction and tibial internal rotation).

The methodological quality of included studies was assessed with the Joanna Briggs Institute checklist for cohort studies. Meta-analyses were performed where two or more studies used similar tasks.

RESULTS

This review demonstrates that there is conflicting evidence for a relationship between hip muscle strength and dynamic lower extremity valgus in female athletes. Five studies reported no relationship between hip muscle strength and dynamic lower extremity valgus. Eight studies found

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