Institut Régional de Formation aux Métiers de Rééducation et de Réadaptation des Pays de la Loire.
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Auteur Nicola Hribar
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Analysis of Kneeling by Medical Imaging Shows the Femur Moves Back to the Posterior Rim of the Tibial Plateau, Prompting Review of the Concave-Convex Rule / Jennie M. Scarvell in Physical Therapy, Vol. 99 n° 3 (March 2019)
[article] Analysis of Kneeling by Medical Imaging Shows the Femur Moves Back to the Posterior Rim of the Tibial Plateau, Prompting Review of the Concave-Convex Rule [texte imprimé] / Jennie M. Scarvell, Auteur ; Nicola Hribar, Auteur ; Catherine R. Galvin, Auteur . - 2019 . - p. 311-318.
Langues : Français (fre)
in Physical Therapy > Vol. 99 n° 3 (March 2019) . - p. 311-318
Catégories : PRATIQUE MÉDICALE
Thesaurus Santé Publique
Résumé : Background: Physical therapists assess joint movement by observation and palpation. New imaging technologies that enable vision of bones and joints during functional activities can be used to analyze joint kinematics and review traditional assumptions.
Purpose: The purpose was to measure relations between flexion, rotation, and translation at the knee and to validate these visually.
Design: This was a prospective, observational study.
Methods: Twenty-five healthy participants aged >45 years (13 males) knelt from upright kneeling to full flexion with the foot free. Fluoroscopy recorded movement at 30 frames per second of x-ray. A computed tomography scan provided 3-dimensional data, which were registered to the fluoroscopy frames to provide a moving model. Motion in 6 degrees of freedom was analyzed for coupling of movements.
Results: Mean (standard deviation) flexion reached by participants was 142 (6)° in kneeling. Posterior femoral translation was coupled to flexion (r = 0.96). From 90° to 150° flexion, the femur translated posteriorly by 36 (3) mm to finish 23 (3) mm posterior to the center of the tibia at 150° flexion. From 90° to 150° flexion, the femur externally rotated from 8 (6)° to 16 (5)°. Flexion was coupled to rotation (r = 0.47). Abduction was Limitations: A limitation of the study is that knee flexion can include squat and lunge as well as kneeling.
Conclusion: Deep flexion requires femoral posterior translation and external rotation. These findings invite review of the concave-convex rule as it might apply to manual therapy of the knee.
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