Manual Therapy, Posturology & Rehabilitation Journal
Manual Therapy, Posturology & Rehabilitation Journal
Research Article

Effects of neuromuscular exercises on q-angle, knee joint stability and ankle mobility of handball athletes.

Marcos Vinicius de Sousa Fernandes, Samuel Ribeiro Carvalho, Wesley dos Santos Costa, Ivan Silveira De Avelar, Deise Aparecida de Almeida Pires Oliveira, Patrícia Espíndola Mota Venâncio, Viviane Soares

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Background: The sport, when it comes to matters related to high performance, can lead the athlete to the development of risk factors for injuries. To minimize the effects of high load training, neuromuscular exercises may offer increased joint stability, thereby reducing risk factors, number of injuries, and minimizing the extent and severity of those that may arise. Objective: To evaluate the effects of neuromuscular exercises on Q-angle, knee joint stability and ankle mobility of high performance handball athletes. Methods: This is a controlled clinical trial conducted with 23 athletes (aged 18 to 37 years), randomly divided into intervention (n = 12) and control (n = 11) groups. Athletes were evaluated with clinical tests for knee joint instability. The risk factors evaluated were ankle range of motion (ROM) in the dorsal flexion movement (tibia over the tarsus) and the Q-angle, which are factors related to ankle sprains and anterior cruciate ligament injury, respectively. A protocol of three neuromuscular exercises for lower limb was applied three times a week, lasting approximately six minutes for 12 sessions. Results: All athletes presented Q-angle higher than expected and in the group that underwent neuromuscular exercises there was a significant reduction in right Q-angle (pre: 23.7 ± 2.9º; post: 20.2 ± 2.5º, p = 0.016) and left (pre: 22.5 ± 2.5º; post: 20.1 ± 1.8º, p = 0.021). The range of motion of both ankles did not increase significantly, but there was an average increase of 2.1º in the right ankle and 2.4º in the left of the athletes who participated in the intervention group. Clinical tests indicated improvement in joint stability. Conclusion: A significant reduction in the right and left Q-angle was observed, as well as reducing the frequency of excessive anterior tibial translocation, which may be positively reflected in the knee joint stability.


Knee Injuries; Proprioception; Neuromuscular; Handball.


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