Patellofemoral Pain Syndrome: Sensitivity Analysis of Muscle Parameters for Expedited Recovery Utilizing an OpenSim Model for Lower Extremities

2018 ◽  
Author(s):  
Adam Novotny ◽  
Manish Paliwal
Keyword(s):  
Knee Joint ◽  
Treatment Plan ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Cross Sectional ◽  
Joint Reaction Forces ◽  
Reaction Forces ◽  
Gastrocnemius Muscles ◽  
Joint Reaction

Patellofemoral pain syndrome (PFPS) is a musculoskeletal condition characterized by anterior knee pain. The symptoms associated with PFPS can be further aggravated through activities that increase patellofemoral compressive forces. Despite the number of mechanisms that are considered to contribute to this disorder, there is no consensus about its etiology, causing difficulty in prescribing the appropriate treatment or physical therapy. To properly evaluate PFPS, the influences of various muscles and their geometries on knee joint reaction forces for a human subject during a normal gait cycle were observed by conducting parametric analysis using OpenSim. The muscles that were seen to be most critical and have a potential effect in reducing the pain experienced at the knee joint are the soleus, iliopsoas, and gastrocnemius muscles. It was observed that individually increasing the length of the soleus and iliopsoas muscles from 75% to 125% of their default lengths resulted in decrease in knee joint reaction forces of up to 400 N (57%) in the x-direction and 600 N (40%) in the y-direction for the soleus and 550 N (38%) in the x-direction and 1000 N (29%) in the y-direction for the iliopsoas. It was also seen that by indirectly reducing the cross-sectional area of the gastrocnemius muscles from 125% to 75% of their default value resulted in decreases in knee joint reaction forces of up to 250 N (50%) in the x-direction and 500 N (42%) in the y-direction. Therefore, exercises should be advised to specifically stretch or strengthen the soleus and iliopsoas, and the gastrocnemius muscles should be rested. Pain and recovery time may be substantially reduced with the utilization of a targeted physiotherapy treatment plan. It can be coupled with longterm physiotherapy program for improving muscle fitness.

scholarly journals VASTUS LATERALIS OBLIQUE ACTIVITY DURING GAIT OF SUBJECTS WITH PATELLOFEMORAL PAIN

2017 ◽  
Vol 23 (2) ◽  
pp. 88-92
Author(s):  
Gilmar Moraes Santos ◽  
Karina Gramani Say ◽  
Flávio Pulzatto ◽  
Thiele de Cássia Libardoni ◽  
Larissa Milani Brognoli Sinhorim ◽  
...  
Keyword(s):  
Knee Joint ◽  
Vastus Lateralis ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Flexion Angle ◽  
Oblique Muscle ◽  
Electromyographic Activity ◽  
Healthy Controls ◽  
Patellar Stability

ABSTRACT Introduction: So far, little is known about the behavior of electromyographic activity of vastus lateralis oblique muscle during treadmill gait in subjects with and without patellofemoral pain syndrome. Objective: The purpose of this study was to investigate the electromyographic activity of the patellar stabilizers muscles and the angle of the knee joint flexion in subjects with and without patellofemoral pain syndrome. Method: Fifteen subjects without (21 ± 3 years) and 12 with patellofemoral pain syndrome (20 ± 2 years) were evaluated. The electromyographic activity and flexion angle of the knee joint were obtained during gait on the treadmill with a 5 degree inclination. Results: The knee flexion angle was significantly lower in the subjects with patellofemoral pain syndrome when compared with the healthy controls. The electromyographic activity of vastus lateralis longus was significantly greater during gait on the treadmill with inclination in subjects with patellofemoral pain syndrome. The results also showed that the electromyographic activity of vastus lateralis oblique and vastus medialis oblique were similar in both groups, regardless of the condition (with/without inclination). Conclusion: We have shown that knee kinematics during gait differs among patients with and without patellofemoral pain syndrome and healthy controls and that a different motor strategy persists even when the pain is no longer present. In addition, the findings suggested that the vastus lateralis oblique has a minor role in patellar stability during gait.

scholarly journals Clinical rearfoot and knee static alignment measurements are not associated with patellofemoral pain syndrome

2012 ◽  
Vol 19 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Sandra Aliberti ◽  
Mariana Souza Xavier Costa ◽  
Sílvia Maria Amado João ◽  
Anice de Campos Pássaro ◽  
Antonio Carlos Arnone ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Cross Sectional ◽  
Q Angle ◽  
Limited Applicability ◽  
Mean Differences ◽  
Continuous Measures ◽  
Control Study

The aim of the present study was to investigate the association between the patellofemoral pain syndrome and the clinical static measurements: the rearfoot and the Q angles. The design was a cross-sectional, observational, case-control study. We evaluated 77 adults (both genders), 30 participants with patellofemoral pain syndrome, and 47 controls. We measured the rearfoot and Q angles by photogrammetry. Independent t-tests were used to compare outcome continuous measures between groups. Outcome continuous data were also transformed into categorical clinical classifications, in order to verify their statistical association with the dysfunction, and χ2 tests for multiple responses were used. There were no differences between groups for rearfoot angle [mean differences: 0.2º (95%CI -1.4-1.8)] and Q angle [mean differences: -0.3º (95%CI -3.0-2.4). No associations were found between increased rearfoot valgus [Odds Ratio: 1.29 (95%CI 0.51-3.25)], as well as increased Q angle [Odds Ratio: 0.77 (95%CI 0.31-1.93)] and the patellofemoral pain syndrome occurrence. Although widely used in clinical practice and theoretically thought, it cannot be affirmed that increased rearfoot valgus and increased Q angle, when statically measured in relaxed stance, are associated with patellofemoral pain syndrome (PFPS). These measures may have limited applicability in screening of the PFPS development.

Comparison of Three-Dimensional Patellofemoral Joint Reaction Forces in Persons With and Without Patellofemoral Pain

2014 ◽  
Vol 30 (4) ◽  
pp. 493-500 ◽  
Author(s):  
Yu-Jen Chen ◽  
Christopher M. Powers
Keyword(s):  
Patellofemoral Joint ◽  
Three Dimensional ◽  
Patellofemoral Pain ◽  
Biomechanical Analysis ◽  
Control Group ◽  
Three Dimensional Model ◽  
Joint Reaction Forces ◽  
Reaction Forces ◽  
Magnetic Resonance Imaging Mri ◽  
Joint Reaction

The purpose of this study was to determine if persons with patellofemoral pain (PFP) exhibit differences in patellofemoral joint reaction forces (PFJRFs) during functional activities. Forty females (20 PFP, 20 controls) underwent two phases of data collection: (1) magnetic resonance imaging (MRI) and (2) biomechanical analysis during walking, running, stair ascent, and stair descent. A previously described three-dimensional model was used to estimate PFJRFs. Resultant PFJRFs and the orthogonal components were reported. The PFP group demonstrated lower peak resultant PFJRFs and posterior component and superior component of the PFJRFs compared with the control group across all conditions. However, the PFP group had a higher peak lateral component of the PFJRF in three out of the four conditions evaluated. The lower resultant PFJRFs suggested that individuals with PFP may employ strategies to minimize patellofemoral joint loading, but it did not result in diminished lateral forces acting on the patella.

scholarly journals Changes in Knee Biomechanics After a Hip-Abductor Strengthening Protocol for Runners With Patellofemoral Pain Syndrome

2011 ◽  
Vol 46 (2) ◽  
pp. 142-149 ◽  
Author(s):  
Reed Ferber ◽  
Karen D. Kendall ◽  
Lindsay Farr
Keyword(s):  
Muscle Strength ◽  
Knee Joint ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Genu Valgum ◽  
Abductor Muscle ◽  
Muscle Strengthening ◽  
Peak Knee ◽  
Hip Abductor

Abstract Context: Very few authors have investigated the relationship between hip-abductor muscle strength and frontal-plane knee mechanics during running. Objective: To investigate this relationship using a 3-week hip-abductor muscle-strengthening program to identify changes in strength, pain, and biomechanics in runners with patellofemoral pain syndrome (PFPS). Design: Cohort study. Setting: University-based clinical research laboratory. Patients or Other Participants: Fifteen individuals (5 men, 10 women) with PFPS and 10 individuals without PFPS (4 men, 6 women) participated. Intervention(s): The patients with PFPS completed a 3-week hip-abductor strengthening protocol; control participants did not. Main Outcome Measure(s): The dependent variables of interest were maximal isometric hip-abductor muscle strength, 2-dimensional peak knee genu valgum angle, and stride-to-stride knee-joint variability. All measures were recorded at baseline and 3 weeks later. Between-groups differences were compared using repeated-measures analyses of variance. Results: At baseline, the PFPS group exhibited reduced strength, no difference in peak genu valgum angle, and increased stride-to-stride knee-joint variability compared with the control group. After the 3-week protocol, the PFPS group demonstrated increased strength, less pain, no change in peak genu valgum angle, and reduced stride-to-stride knee-joint variability compared with baseline. Conclusions: A 3-week hip-abductor muscle-strengthening protocol was effective in increasing muscle strength and decreasing pain and stride-to-stride knee-joint variability in individuals with PFPS. However, concomitant changes in peak knee genu valgum angle were not observed.

scholarly journals Braking and propulsive impulses in individuals with patellofemoral pain syndrome when walking up and down stairs

2014 ◽  
Vol 20 (4) ◽  
pp. 442-447
Author(s):  
Marcelo Camargo Saad ◽  
Renato Moraes ◽  
Lilian Ramiro Felicio ◽  
Débora Bevilaqua-Grossi
Keyword(s):  
Clinical Condition ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Ground Reaction Forces ◽  
Healthy Controls ◽  
Painful Condition ◽  
Motor Strategy ◽  
Reaction Forces ◽  
Biomechanical Parameters

Patellofemoral pain syndrome (PFPS) is a prevalent clinical condition and it affects gait behavior. Braking and propulsive impulses are important biomechanical parameters obtained from ground reaction forces (GRF), which combine the amount of force applied over a period of time. The aim of this study was to evaluate these impulses while walking up and down stairs in healthy controls and PFPS individuals. The results did not reveal significant differences in braking and propulsive impulses between groups during these activities. Thus, the painful condition on a simple functional activity was insufficient to change the motor strategy to walking up or down the stairs.

scholarly journals Abnormal knee joint position sense in individuals with patellofemoral pain syndrome

2002 ◽  
Vol 20 (2) ◽  
pp. 208-214 ◽  
Author(s):  
Vanessa Baker ◽  
Kim Bennell ◽  
Barry Stillman ◽  
Sallie Cowan ◽  
Kay Crossley
Keyword(s):  
Knee Joint ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Position Sense ◽  
Patellofemoral Pain ◽  
Joint Position Sense ◽  
Joint Position
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