Increased Femoral Anteversion and Physical Performance
Condition: High Femoral Anteversion; Muscle Strength; Flexibility; Functional Performance; Functional Capacity
Study type: Observational

Summary: 
      It is important to determine how high femoral anteversion, which is one of the lower
      extremity malalignments, affects physical performance and to what extent it affects the daily
      life of the individual. As far as we know, there is no study on this subject except for a
      study conducted by Staheli et al. in 1977. Therefore, the investigators planned to determine
      whether and to what extent high femoral anteversion has an effect on physical performance in
      healthy young adults.
    

Detailed description: 
      One of the factors associated with problems in the lower extremity is changes in the angle of
      femoral anteversion. High femoral anteversion causes pathological changes in the sagittal and
      coronal planes, especially in the transverse plane, and changes the gait biomechanics.
      Femoral anteversion angle; It is the angle formed by the plane of the femoral condyle and the
      plane passing through the femoral neck and the femoral head. The femoral anteversion angle,
      which is 55°-60° in the intrauterine period, is approximately 30° at birth. In the postnatal
      period, with normal growth, it decreases by 1.5° per year until the age of 15, decreasing to
      26° at the age of 5, 21° at the age of 9 and 15° at the age of 16.

      Toe-in gait pattern may be due to foot deformity (metatarsus adductus) and/or transverse
      alignment disorder of the long bones (tibial torsion and/or femoral anteversion height). When
      the angle of anterversion is high, walking with the feet turned in is 30.9% at the age of 4,
      15% at the age of 4, and around 4% in adults. High femoral anteversion, which is the most
      common cause of inward walking in early childhood, is mostly seen symmetrically, with a
      higher incidence in girls and hypermobile children. Most cases are idiopathic and some
      patients have a familial predisposition.

      Alignment disorders in the lower extremities can cause problems affecting other segments of
      the body, postural disorders and problems in the musculoskeletal system, as well as affect
      physical performance. The study, which will examine the physical performance status of young
      adults with high femoral anteversion, will be carried out as a cross-sectional study. The
      universe of the study will consist of students aged 17-26 who continue their education at the
      Faculty of Health Sciences of Bezmialem Vakıf University in the 2022-2023 academic year.
      Within the scope of our cross-sectional study, an application will be made for the approval
      of the Ethics Committee before the data are collected. The study, which will start after the
      permission is obtained, will be carried out in accordance with the Declaration of Helsinki.
      Evaluation and testing of all cases will be done at Bezmialem Vakif University, Faculty of
      Health Sciences, Department of Physiotherapy and Rehabilitation. 22 subjects with high
      femoral anteversion angle and 22 subjects with normal femoral anteversion angle will be
      included in the study. Within the scope of the study, demographic information of all
      participants will be obtained with the evaluation form and clinical evaluations will be made.
      Flexibility with sit-reach test, hand grip strength with hydraulic hand dynamometer, general
      muscle strength with analog back-leg-chest dynamometer, functional performance with
      single-leg and double-leg horizontal jump tests, and functional capacities with 6-minute
      walking test will be evaluated. "Statistical Package for the Social Sciences (SPSS) 20.0 for
      Windows" package program will be used in the statistical analysis of the data obtained from
      the study which the investigators planned to evaluate physical performance in young adults
      with high femoral anteversion. All data will be analyzed with the Kolmogorov-Smirnov test to
      determine the distribution characteristics. In the study, descriptive statistics
      (mean±standard deviation, minimum-maximum, number and percentile) will be given for discrete
      and continuous variables. When the differences between two independent groups are evaluated,
      "t-Test in Independent Groups" in case the parametric test prerequisites are met; If not, the
      "Mann Whitney -U Test" will be used. "Chi-Square Test" will be used to determine the
      relationships between two discrete variables. When the variables meet the parametric test
      prerequisites, the correlation coefficients and statistical significance will be calculated
      with the "Pearson Test", when they do not, the correlation coefficients and statistical
      significance for the relations between the variables will be calculated with the "Spearman
      Test".
    

Intervention name(s): Sit and reach test; Hand grip strength measurement; Back-leg-chest muscle strength measurement; Functional performance; Functional capacity
Intervention type(s): Other; Other; Other; Other; Other
Intervention description(s): It will be used to measure the flexibility of the participants.; Grip strength will be evaluated with a hand dynamometer in the position recommended by the American Association of Hand Therapists.; An analog Back Leg-Chest dynamometer will be used to evaluate general muscle strength.; Single-leg and double-leg horizontal jump test will be used to evaluate lower extremity functional performance. The tests will be carried out according to the Eurofit test battery (Council of Europe, 1988).; Functional capacity will be evaluated with six minute walk test according to the ATS criteria.
Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        22 young adults aged 17-26 years with high femoral anteversion.