Influence of the exacerbation of patellofemoral pain on trunk kinematics and lower limb mechanics during stair negotiation

Context There is limited evidence indicating the contribution of trunk kinematics to patellofemoral pain (PFP). A better understanding of the interaction between trunk and lower extremity kinematics in this population may provide new avenues for interventions to treat PFP. Objective To compare trunk and lower extremity kinematics between participants with PFP and healthy controls during a stair-descent task. Design Cross-sectional study. Setting Research laboratory. Patients or Other Participants Twenty women with PFP (age = 22.2 ± 3.1 years, height = 164.5 ± 9.2 cm, mass = 63.5 ± 13.6 kg) and 20 healthy women (age = 21.0 ± 2.6 years, height = 164.5 ± 7.1 cm, mass = 63.8 ± 12.7 kg). Intervention(s) Kinematics were recorded as participants performed stair descent at a controlled velocity. Main Outcome Measure(s) Three-dimensional joint displacement of the trunk, hip, and knee during the stance phase of stair descent for the affected leg was measured using a 7-camera infrared optical motion-capture system. Pretest and posttest pain were assessed using a visual analogue scale. Kinematic differences between groups were determined using independent-samples t tests. A 2 × 2 mixed-model analysis of variance (group = PFP, control; time = pretest, posttest) was used to compare knee pain. Results We observed greater knee internal-rotation displacement for the PFP group (12.8° ± 7.2°) as compared with the control group (8.9° ± 4.4°). No other between-groups differences were observed for the trunk, hip, or other knee variables. Conclusions We observed no difference in trunk kinematics between groups but did note differences in knee internal-rotation displacement. These findings contribute to the current knowledge of altered movement in those with PFP and provide direction for exercise interventions.

Download Full-text

Effects of gait retraining with focus on impact versus gait retraining with focus on cadence on pain, function and lower limb kinematics in runners with patellofemoral pain: Protocol of a randomized, blinded, parallel group trial with 6-month follow-up

PLoS ONE ◽

10.1371/journal.pone.0250965 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0250965

Author(s):

José Roberto de Souza Júnior ◽

Pedro Henrique Reis Rabelo ◽

Thiago Vilela Lemos ◽

Jean-Francois Esculier ◽

João Pedro da Silva Carto ◽

...

Keyword(s):

Lower Limb ◽

Intervention Group ◽

Patellofemoral Pain ◽

Control Group ◽

Gait Retraining ◽

Positive Effects ◽

Clinical Applicability ◽

Limb Kinematics ◽

Lower Limb Kinematics

Patellofemoral pain (PFP) is one of the most prevalent injuries in runners. Unfortunately, a substantial part of injured athletes do not recover fully from PFP in the long-term. Although previous studies have shown positive effects of gait retraining in this condition, retraining protocols often lack clinical applicability because they are time-consuming, costly for patients and require a treadmill. The primary objective of this study will be to compare the effects of two different two-week partially supervised gait retraining programs, with a control intervention; on pain, function and lower limb kinematics of runners with PFP. It will be a single-blind randomized clinical trial with six-month follow-up. The study will be composed of three groups: a group focusing on impact (group A), a group focusing on cadence (group B), and a control group that will not perform any intervention (group C). The primary outcome measure will be pain assessed using the Visual Analog Pain scale during running. Secondary outcomes will include pain during daily activities (usual), symptoms assessed using the Patellofemoral Disorders Scale and lower limb running kinematics in the frontal (contralateral pelvic drop; hip adduction) and sagittal planes (foot inclination; tibia inclination; ankle dorsiflexion; knee flexion) assessed using the MyoResearch 3.14—MyoVideo (Noraxon U.S.A. Inc.). The study outcomes will be evaluated before (t0), immediately after (t2), and six months (t24) after starting the protocol. Our hypothesis is that both partially supervised gait retraining programs will be more effective in reducing pain, improving symptoms, and modifying lower limb kinematics during running compared with the control group, and that the positive effects from these programs will persist for six months. Also, we believe that one gait retraining group will not be superior to the other. Results from this study will help improve care in runners with PFP, while maximizing clinical applicability as well as time and cost-effectiveness.

Download Full-text

Full gait cycle analysis of lower limb and trunk kinematics and muscle activations during walking in participants with and without ankle instability

Gait & Posture ◽

10.1016/j.gaitpost.2018.06.001 ◽

2018 ◽

Vol 64 ◽

pp. 114-118 ◽

Cited By ~ 5

Author(s):

Lynsey Northeast ◽

Charlotte N. Gautrey ◽

Lindsay Bottoms ◽

Gerwyn Hughes ◽

Andrew C.S. Mitchell ◽

...

Keyword(s):

Lower Limb ◽

Gait Cycle ◽

Ankle Instability ◽

Trunk Kinematics ◽

Muscle Activations

Download Full-text

The effect of footwear and cadence on lower limb variability in runners with patellofemoral pain

Journal of Science and Medicine in Sport ◽

10.1016/j.jsams.2018.09.118 ◽

2018 ◽

Vol 21 ◽

pp. S51-S52

Author(s):

J. Bonacci ◽

A. Fox ◽

J. Fuller ◽

M. Hall ◽

B. Vicenzino

Keyword(s):

Lower Limb ◽

Patellofemoral Pain

Download Full-text

Influence of the Powers™ strap on pain and lower limb biomechanics in individuals with patellofemoral pain

The Knee ◽

10.1016/j.knee.2019.03.005 ◽

2019 ◽

Vol 26 (6) ◽

pp. 1210-1219 ◽

Cited By ~ 1

Author(s):

Henrike Greuel ◽

Lee Herrington ◽

Anmin Liu ◽

Richard K. Jones

Keyword(s):

Lower Limb ◽

Patellofemoral Pain

Download Full-text

Effects of exercise combined with whole body vibration in patients with patellofemoral pain syndrome: a randomised-controlled clinical trial

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03599-2 ◽

2020 ◽

Vol 21 (1) ◽

Cited By ~ 2

Author(s):

Angel Yañez-Álvarez ◽

Beatriz Bermúdez-Pulgarín ◽

Sergio Hernández-Sánchez ◽

Manuel Albornoz-Cabello

Keyword(s):

Clinical Trial ◽

Lower Limb ◽

Repeated Measures ◽

Whole Body Vibration ◽

Patellofemoral Pain ◽

Whole Body ◽

Control Group ◽

Body Vibration ◽

And Function ◽

Experimental Group

Abstract Background Patellofemoral pain is a prevalent condition in the general population, especially in women, and produces functional impairment in patients. Therapeutic exercise is considered an essential part of the conservative management. The use of vibration platforms may help improve strength and function and reduce pain in patients with knee disorders. The aim of this investigation was to determine the effects of adding whole body vibration (vertical, vibration frequency of 40 Hz, with an amplitude from 2 to 4 mm) to an exercise protocol for pain and disability in adults with patellofemoral pain. Methods A randomised clinical trial was designed, where 50 subjects were randomly distributed into either an exercise group plus whole body vibration or a control group. Pain, knee function (self-reported questionnaire) and range of motion and lower limb functionality were assessed at baseline and at 4 weeks. The experimental group performed 12 supervised sessions of hip, knee and core strengthening exercises on a vibration platform 3 times per week during 4 weeks. The control group followed the same protocol but without vibration stimuli. Differences in outcome measures were explored using an analysis of the variance of 2 repeated measures. Effect sizes were estimated using Square Eta (η2). Significant level was set al P < 0.05. Results Statistically significant differences were found after intervention in favour of the experimental group in the between-groups comparison and in the interaction of the experimental group before and after treatment in terms of pain perception (P = 0.000; η2 = 0.63) and function outcomes scores (P = 0.000; η2 0.39 and 0.51 for lower limb functional scale and Kujala scores respectively). Conclusion A 4-week whole body vibration exercise programme reduces pain level intensity and improves lower limb functionality in patellofemoral pain patients and is more effective than exercise alone in improving pain and function in the short-term. Trial registration ClinicalTrials.gov (NCT04031248). This study was prospectively registered on the 24th July, 2019.

Download Full-text

INFLUENCE OF THE COMPLEX CORRECTION TECHNIQUE TO STRENGTH OF THE QUADRICEPS FEMORIS MUSCLE OF PATIENTS WITH PATELLOFEMORAL PAIN SYNDROME

Russian Journal of Physiotherapy Balneology and Rehabilitation ◽

10.18821/1681-3456-2018-17-2-72-75 ◽

2018 ◽

Vol 17 (2) ◽

pp. 72-75

Author(s):

Elena Sergeevna Prokhorova ◽

V. V Ar’kov ◽

M. R Makarova

Keyword(s):

Knee Joint ◽

Lower Limb ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Quadriceps Femoris ◽

Main Group ◽

Lumbosacral Spine ◽

Outpatient Basis ◽

Correction Technique

In 40 patients with patellofemoral pain syndrome, before and after the course of treatment, the strength indices of the hip muscles were studied by isokinetic dynamometry, as well as the severity of the pain syndrome in the knee joint and the lumbosacral spine according to the visual analogue scale. The patients of the main group (n = 20) used the technique of complex correction of the pelvic region and lower limb, which was mainly aimed at stabilizing the lumbosacral spine. Patients of the control group (n = 20) performed therapeutic gymnastics aimed at training the muscles of only the interested lower limb. The treatment was performed on an outpatient basis daily for 21 days. After the course of treatment in patients of the main group, the strengths of the quadriceps femoris were significantly higher (p < 0.05), and the degree of pain in the knee joint and lumbar spine was significantly lower (p < 0.05). The obtained data confirm the necessity and expediency of including exercises for stabilization of the lumbosacral spine in the rehabilitation program for patients with patellofemoral pain syndrome.

Download Full-text