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Are physical fitness, a history of childbirth and injury history related to knee valgus in female Canadian Armed Forces members during a bodyweight overhead squat movement?
  1. Chris Margaret Edwards1,
  2. D da Silva2,
  3. J L Puranda1,
  4. É Miller1,
  5. K Semeniuk1 and
  6. K B Adamo1
  1. 1Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
  2. 2Department of Sports Studies, Bishop’s University, Sherbrooke, Quebec, Canada
  1. Correspondence to Dr K B Adamo, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; kadamo{at}uottawa.ca

Abstract

Objectives A history of childbirth is associated with musculoskeletal injury (MSKi) in female members of the Canadian Armed Forces (CAF). While previous injury and pregnancy impact knee kinematics, it is unclear if a history of childbirth is associated with medial knee displacement (MKD) in an overhead squat movement screen. The aim of this study is to examine the relationship between MKD and (1) MSKi and (2) parity status in female CAF members.

Methods 24 nulliparous and 21 parous female participants employed by the CAF completed a comprehensive physical fitness assessment of muscular flexibility, power, strength, endurance, aerobic capacity and a bodyweight overhead squat movement screen (recorded using two-dimensional video, and hip–knee–ankle angle measured using Kinovea software). Interactions between MKD, parity status and MSKi history were assessed by one-way analysis of variance and two-way analysis of covariance (ANCOVA) (adjusted for age).

Results An interaction between parity status and acute injury of the lower extremity was observed (F=4.379, p=0.043, η2=0.099) in MKD of the right knee. The two-way ANCOVA examining acute injury of the lumbopelvic hip complex (lower back, pelvis, hip) yielded an interaction between acute injury to the lumbopelvic hip complex and parity status (F=4.601, p=0.038, η2=0.103) in MKD asymmetry.

Discussion Parous participants with acute injury to the lower extremity had larger MKD than parous without this injury type. Parous participants without acute injury to the lumbopelvic hip complex had greater MKD asymmetry than nulliparous without this injury type. Our findings suggest that researchers and clinicians should consider parity status in conjunction with MSKi history when assessing knee kinematics in female military members.

  • reproductive medicine
  • physiology
  • rehabilitation medicine
  • sports medicine

Data availability statement

Data are available upon reasonable request. Data generated or analysed during this study are not publicly available due to agreements with grant provider due to the population (active-duty military members) included in this study but are available from the corresponding author on reasonable request and approval by collaborators.

https://doi.org/10.1136/military-2023-002653

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    Data availability statement

    Data are available upon reasonable request. Data generated or analysed during this study are not publicly available due to agreements with grant provider due to the population (active-duty military members) included in this study but are available from the corresponding author on reasonable request and approval by collaborators.

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    Footnotes

    • Contributors CME, DdS, JLP, KS and KBA created the questionnaire used for this study. Participant communication and scheduling were performed by CME. Study site coordination and logistics were performed by CME. Equipment procurement was conducted by KS, DdS and CME. Data collection for the squat test was performed by CME. Data collection for the other tests included in the protocol was performed by CME, EM, DdS, JLP and KS. Data cleaning for the questionnaire and physical testing were performed by CME, DdS and JLP. Video collection, calibration, overhead squat movement analysis and data analysis for this study were performed by CME. Funding grant was procured by KBA, DdS and KS. All authors contributed to editing, reading and approving the final version of the manuscript. KBA acts as guarantor.

    • Funding Canadian Department of National Defence (DND), Innovation for Defence Excellence and Security (IDEaS) Program (W7714-207286/001/SV1).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.