scholarly journals Lower Extremity Strength and Mechanics during Jumping in Women with Patellofemoral Pain

2009 ◽  
Vol 18 (1) ◽  
pp. 76-90 ◽  
Author(s):  
John D. Willson ◽  
Irene S. Davis
Keyword(s):  
Lower Extremity ◽  
Outcome Measures ◽  
External Rotation ◽  
Weight Bearing ◽  
Pain Syndrome ◽  
Knee Extension ◽  
Patellofemoral Pain ◽  
Control Group ◽  
Trunk Flexion ◽  
Hip Abduction

Context:Lower extremity (LE) weakness might be associated with altered mechanics during weight bearing in subjects with patellofemoral pain syndrome (PFPS).Objective:To analyze LE strength, mechanics, and the association between these variables among women with and without PFPS during a simulated athletic task.Design:Case control.Setting:Motion-analysis laboratory.Subjects:20 women with PFPS and 20 healthy women.Main Outcome Measures:Peak isometric lateral trunk-flexion, hip-abduction, hip external-rotation, knee-flexion, and knee-extension strength, as well as hip- and knee-joint excursions and angular impulses during single-leg jumps.Results:PFPS subjects produced less hip-abduction, hip external-rotation, and trunk lateral-flexion force than the control group. The PFPS group also demonstrated greater hip-adduction excursion and hip-abduction impulses. The association between the strength measurements and LE mechanics was low.Conclusions:Women with PFPS demonstrate specific weaknesses and altered LE mechanics. Weakness is not, however, highly correlated with observed differences in mechanics.

scholarly journals Eccentric Hip Muscle Function in Females With and Without Patellofemoral Pain Syndrome

2009 ◽  
Vol 44 (5) ◽  
pp. 490-496 ◽  
Author(s):  
Rodrigo de Marche Baldon ◽  
Theresa Helissa Nakagawa ◽  
Thiago Batista Muniz ◽  
César Ferreira Amorim ◽  
Carlos Dias Maciel ◽  
...  
Keyword(s):  
Muscle Function ◽  
External Rotation ◽  
Pain Syndrome ◽  
Peak Torque ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Control Group ◽  
Hip Muscle ◽  
Hip Abduction ◽  
Torque Values

Abstract Context: Patellofemoral pain syndrome (PFPS) is a common knee condition in athletes. Recently, researchers have indicated that factors proximal to the knee, including hip muscle weakness and motor control impairment, contribute to the development of PFPS. However, no investigators have evaluated eccentric hip muscle function in people with PFPS. Objective: To compare the eccentric hip muscle function between females with PFPS and a female control group. Design: Cross-sectional study. Setting: Musculoskeletal laboratory. Patients or Other Participants: Two groups of females were studied: a group with PFPS (n  =  10) and a group with no history of lower extremity injury or surgery (n  =  10). Intervention(s): Eccentric torque of the hip musculature was evaluated on an isokinetic dynamometer. Main Outcome Measure(s): Eccentric hip abduction, adduction, and external and internal rotation peak torque were measured and expressed as a percentage of body mass (Nm/kg × 100). We also evaluated eccentric hip adduction to abduction and internal to external rotation torque ratios. The peak torque value of 5 maximal eccentric contractions was used for calculation. Two-tailed, independent-samples t tests were used to compare torque results between groups. Results: Participants with PFPS exhibited much lower eccentric hip abduction (t18  =  −2.917, P  =  .008) and adduction (t18  =  −2.764, P  =  .009) peak torque values than did their healthy counterparts. No differences in eccentric hip external (t18  =  0.45, P  =  .96) or internal (t18  =  −0.742, P  =  .47) rotation peak torque values were detected between the groups. The eccentric hip adduction to abduction torque ratio was much higher in the PFPS group than in the control group (t18  =  2.113, P  =  .04), but we found no difference in the eccentric hip internal to external rotation torque ratios between the 2 groups (t18  =  −0.932, P  =  .36). Conclusions: Participants with PFPS demonstrated lower eccentric hip abduction and adduction peak torque and higher eccentric adduction to abduction torque ratios when compared with control participants. Thus, clinicians should consider eccentric hip abduction strengthening exercises when developing rehabilitation programs for females with PFPS.

Relationship of Knee Motions With Static Leg Alignments and Hip Motions in Frontal and Transverse Planes During Double-Leg Landing in Healthy Athletes

2017 ◽  
Vol 26 (5) ◽  
pp. 396-405 ◽  
Author(s):  
Shogo Uota ◽  
Anh-Dung Nguyen ◽  
Naoko Aminaka ◽  
Yohei Shimokochi
Keyword(s):  
Lower Extremity ◽  
Outcome Measures ◽  
External Rotation ◽  
Weight Bearing ◽  
Patellofemoral Pain ◽  
Transverse Plane ◽  
Knee Valgus ◽  
Chronic Knee Pain ◽  
Lower Extremity Alignment ◽  
Peak Knee

Context:Excessive knee valgus and tibial external rotation relative to the femur during weight bearing motions, such as jump-landing, reportedly increases the risk of developing chronic knee pain, such as patellofemoral pain. Excessive deviations from normal ranges of several static lower extremity alignment measures and dynamic hip motions may also increase the risks for patellofemoral pain.Objective:To determine the relationship between lower extremity alignments and hip motions to frontal and transverse plane knee motions during double-leg landings.Design:Correlational study.Setting:Laboratory.Patients or Other Participants:69 healthy, competitive athletes (27 men, 42 women; height, 166.5 ± 9.5 cm; weight, 61.3 ± 9.9 kg; age, 20.7 ± 1.0 y) participated in this study.Interventions:Prone and supine hip version, quadriceps angle, and tibiofemoral angle were measured. Frontal and transverse knee and hip angles at peak knee extensor moment during landing were calculated.Main Outcome Measures:2 separate stepwise multiple regression analyses were conducted to predict frontal and transverse plane knee motions using 4 static lower extremity alignment measures and hip motions.Results:Greater hip adduction and prone hip anteversion, and lesser hip internal rotation and supine hip anteversion, were related to greater knee valgus motions (R2 = .475, P < .01). Greater hip adduction was related to greater knee external rotation (R2 = .205, P < .01).Conclusions:Some targeted static lower extremity alignments and hip motions are associated with frontal and transverse knee motions. However, stronger relationships of hip motions with knee motions than static lower extremity alignments provided evidence that improving hip movements may help improve patellofemoral pain in those with lower extremity malalignments.

A Randomized Controlled Pilot Study to Investigate the Effect of Whole-Body Vibration on Lower-Extremity Fatigue

2017 ◽  
Vol 26 (5) ◽  
pp. 339-346 ◽  
Author(s):  
Noureddin Nakhostin Ansari ◽  
Soofia Naghdi ◽  
Hadi Karimi-Zarchi ◽  
Zahra Fakhari ◽  
Scott Hasson
Keyword(s):  
Pilot Study ◽  
Lower Extremity ◽  
Outcome Measures ◽  
Weight Bearing ◽  
Whole Body Vibration ◽  
Young Men ◽  
Whole Body ◽  
Control Group ◽  
Body Vibration ◽  
Randomized Controlled

Context:Whole-body vibration (WBV) is a type of weight-bearing exercise used in the field of sport and rehabilitation. There is no study on the effects of WBV on muscle recovery after a fatiguing activity.Objective:To determine the effects of a single WBV session on lower-extremity fatigue.Design:Randomized controlled pilot study.Setting:University Physiotherapy Clinic.Subjects:A total of 13 healthy young men volunteered to participate in this study. Subjects were randomly assigned into the WBV group (n = 7, mean age: 21 y) or control group (CG; n = 6, mean age: 20 y).Intervention:Subjects in the WBV group participated in a single-session WBV (30 Hz, amplitude 4 mm, 2 min) after lower-extremity fatigue.Main Outcome Measures:Peak force of quadriceps muscle, single leg hop test, and Y-test were measured before inducing muscle fatigue (T0), immediately after completing the fatigue protocol (T1), after WBV (T2), and 15 min following the application of WBV (T3). The same method was applied in the CG while the WBV machine was turned off.Results:Repeated-measure ANOVA revealed no significant differences between groups in any of the outcomes.Conclusions:The findings indicated that WBV was not effective in the recovery of lower-extremity fatigue in healthy young men.

Correlations between Hip Strength and Static Foot and Knee Posture

2006 ◽  
Vol 15 (1) ◽  
pp. 12-23 ◽  
Author(s):  
John H. Hollman ◽  
Kimberly E. Kolbeck ◽  
Jamie L. Hitchcock ◽  
Jonathan W. Koverman ◽  
David A. Krause
Keyword(s):  
Lower Extremity ◽  
Outcome Measures ◽  
External Rotation ◽  
Correlation Coefficients ◽  
Lower Extremity Injuries ◽  
Longitudinal Arch ◽  
Q Angle ◽  
Hip Muscle ◽  
Hip Abduction ◽  
Extremity Injuries

Context:Hip-muscle weakness might be associated with impaired biomechanics and postures that contribute to lower extremity injuries.Objective:To examine relationships between hip-muscle strength, Q angle, and foot pronation.Design:Correlational study.Setting:Academic laboratory.Participants:33 healthy adults.Main Outcome Measures:Maximal isometric hip abduction (Abd), adduction (Add), external-rotation (ER) and internal-rotation (IR) strength; Q angle of the knee; and longitudinal arch angle of the foot. We analyzed Pearson product– moment (r) correlation coefficients between the Abd/Add and ER/IR force ratios, Q angle, and longitudinal arch angle.Results:The hip Abd/Add force ratio was correlated with longitudinal arch angle (r= .35,P= .025).Conclusions:Reduced strength of the hip abductors relative to adductors is associated with increased pronation at the foot. Clinicians should be aware of this relationship when examining patients with lower extremity impairments.

scholarly journals Concentric and Eccentric Torque of the Hip Musculature in Individuals With and Without Patellofemoral Pain

2009 ◽  
Vol 44 (1) ◽  
pp. 7-13 ◽  
Author(s):  
Michelle C. Boling ◽  
Darin A. Padua ◽  
R. Alexander Creighton
Keyword(s):  
Knee Pain ◽  
External Rotation ◽  
Patellofemoral Pain ◽  
Stair Climbing ◽  
Lower Extremity Injury ◽  
Control Group ◽  
Prior History ◽  
Pain Group ◽  
Limited Participation ◽  
Hip Abduction

Abstract Context: Individuals suffering from patellofemoral pain have previously been reported to have decreased isometric strength of the hip musculature; however, no researchers have investigated concentric and eccentric torque of the hip musculature in individuals with patellofemoral pain. Objective: To compare concentric and eccentric torque of the hip musculature in individuals with and without patellofemoral pain. Design: Case control. Setting: Research laboratory. Patients or Other Participants: Twenty participants with patellofemoral pain (age  =  26.8 ± 4.5 years, height  =  171.8 ± 8.4 cm, mass  =  72.4 ± 16.8 kg) and 20 control participants (age  =  25.6 ± 2.8 years, height  =  169.5 ± 8.9 cm, mass  =  70.0 ± 16.9 kg) were tested. Volunteers with patellofemoral pain met the following criteria: knee pain greater than or equal to 3 cm on a 10-cm visual analog scale, insidious onset of symptoms not related to trauma, pain with palpation of the patellar facets, and knee pain during 2 of the following activities: stair climbing, jumping or running, squatting, kneeling, or prolonged sitting. Control participants were excluded if they had a prior history of patellofemoral pain, knee surgery in the past 2 years, or current lower extremity injury that limited participation in physical activity. Intervention(s): Concentric and eccentric torque of the hip musculature was measured on an isokinetic dynamometer. All volunteers performed 5 repetitions of each strength test. Separate multivariate analyses of variance were performed to compare concentric and eccentric torque of the hip extensors, abductors, and external rotators between groups. Main Outcome Measure(s): Average and peak concentric and eccentric torque of the hip extensors, abductors, and external rotators. Torque measures were normalized to the participant's body weight multiplied by height. Results: The patellofemoral pain group was weaker than the control group for peak eccentric hip abduction torque (F1,38  =  6.630, P  =  .014), and average concentric (F1,38  =  4.156, P  =  .048) and eccentric (F1,38  =  4.963, P  =  .032) hip external rotation torque. Conclusions: The patellofemoral pain group displayed weakness in eccentric hip abduction and hip external rotation, which may allow for increased hip adduction and internal rotation during functional movements.

scholarly journals Correlation between Dorsiflexion Ankle Range of Motion and Patellofemoral Pain Syndrome

2018 ◽  
Vol 20 (2) ◽  
pp. 135
Author(s):  
Isabella Pereira Da Silva ◽  
Baldomero Antonio Kato da Silva ◽  
Daniel Martins Pereira ◽  
Ana Carolina Dos Santos Demarchi ◽  
Silvio Assis de Oliveira-Junior ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Cruciate Ligament ◽  
Weight Bearing ◽  
Movement Pattern ◽  
Pain Syndrome ◽  
Patellofemoral Pain ◽  
Patellar Tendinopathy ◽  
Iliotibial Band ◽  
Control Group ◽  
Iliotibial Band Syndrome

Abstract The change in lower extremity movement pattern has been previously associated with severe knee disorders, including anterior cruciate ligament rupture, patellar tendinopathy, iliotibial band syndrome, and patellofemoral pain (PFP). The aim of this study was to verify the clinical reliability of ankle dorsiflexion range of motion (ADROM) measurement with weight bearing (WB) using an app on the smartphone (iHand) and to verify if there is correlation between the limitation of the ADROM and the PFP. A total of 67 women, mean age 34.3 ± 2.4, height 182 ± 3.6, weight 73.7 ± 4.2, were allocated to the control group (n = 23) and the PFP group (n = 23). Two examiners evaluated the active ADROM (lunge test) in both ankles at two times to test inter-examiner and intra-examiner reliability. It was observed in the PFP group that the mean ADROM was 17.7 ± 2.5 and the control group was 35.3 ± 6.2 (right) and 17.1 ± 2.9 and 32.9 ± 5, 4 (left). It is concluded that the use of the smartphone app proved to be reliable for clinical application in the evaluation of ADROM with WB and that there is a relation between the low DFT of DFT with the presence of patellofemoral pain.Keywords: Data Accuracy. Ankle. Patellofemoral Pain Syndrome.Resumo A alteração no padrão de movimento da extremidade inferior tem sido previamente associada com severas desordens do joelho, incluindo a ruptura do ligamento cruzado anterior, tendinopatia patelar, síndrome da banda iliotibial e dor patelofemoral - DPF. O objetivo do estudo foi verificar a confiabilidade clínica da mensuração da dorsiflexão de tornozelo - DFT com descarga de peso - WB utilizando um app no smartphone (iHand) e verificar se há correlação entre a limitação da DFT com a DPF. Participaram 67 mulheres, idade média 34,3±2,4, altura 182±3,6, peso 73,7±4,2, alocadas em grupo controle (n=23) e grupo DFP (n=23). Dois examinadores avaliaram a DFT ativa (lunge test) em ambos os tornozelos em dois momentos para se testar a confiabilidade inter-examinador e intra-examinador. O coeficiente de correlação intraclasse - CCI foi utilizado para a análise da confiabilidade das medidas. Observou-se alta confiabilidade (0,9965 [p<0,0001]) e (0,9949 [p<0,0001]) para tornozelo direito e esquerdo respectivamente. Observou-se no grupo DFP que a ADM média de DFT foi de 17,7±2,5 e grupo controle de 35,3±6,2 (direito) e 17,1±2,9 e 32,9±5,4 (esquerdo). Conclui-se que a utilização do app de smartphone se mostrou confiável para aplicação clínica na avaliação da DFT com WB e que há relação entre a baixa ADM de DFT com a presença de dor patelofemoral.Palavras-chave: Acurácia dos Dados. Tornozelo. Síndrome da Dor Patelofemoral

No Difference in Gluteus Medius Activation in Women With Mild Patellofemoral Pain

2012 ◽  
Vol 21 (2) ◽  
pp. 110-118 ◽  
Author(s):  
Kieran O’Sullivan ◽  
Ellen Herbert ◽  
David Sainsbury ◽  
Karen McCreesh ◽  
Amanda Clifford
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Muscle Activation ◽  
Weight Bearing ◽  
Pain Syndrome ◽  
Gluteus Medius ◽  
Patellofemoral Pain ◽  
Stair Climbing ◽  
Convenience Sample ◽  
Healthy Participants

Context:The gluteus medius (Gmed) is proposed to consist of 3 functional subdivisions (anterior, middle, and posterior). Gmed weakness and dysfunction have been implicated in numerous lower extremity disorders, including patellofemoral pain syndrome (PFPS). PFPS is a knee condition that frequently occurs in females and is associated with activities such as squatting and stair climbing. There is a lack of evidence for the role of the subdivisions of the Gmed in females with and without PFPS.Objective:To compare muscle activation in the 3 Gmed subdivisions during 4 weight-bearing exercises in women with and without PFPS.Design:Single-session, repeated-measures observational study.Setting:University research laboratory.Participants:Convenience sample of 12 women with PFPS and 12 age- and gender-matched asymptomatic controls.Intervention:Participants performed 4 weight-bearing exercises (wall press, pelvic drop, step-up-and-over, and unilateral squat) 3 times while surface electromyography (sEMG) activity of the Gmed segments was recorded.Main Outcome Measures:sEMG muscle activity for each functional subdivision of the Gmed during each weight-bearing exercise was analyzed using a mixed between–within-subjects ANOVA (post hoc Bonferroni).Results:No statistically significant differences in muscle activation were found between the PFPS and healthy participants (P = .97). Furthermore, there were no statistically significant differences between the exercises (P = .19) or muscle fibers (P = .36) independent of group analyzed. However, the activation of the subdivisions varied according to the exercise performed (P = .003).Conclusions:Similar levels of muscle activation were recorded in the Gmed subdivisions of the PFPS and healthy participants during the different exercises. This is the first study to examine all 3 Gmed subdivisions in PFPS. Future studies using larger sample sizes should also investigate onset and duration of muscle activation in all Gmed subdivisions in both healthy individuals and those with PFPS.

The Effectiveness of Exercise in Treating Patellofemoral-Pain Syndrome

2004 ◽  
Vol 13 (4) ◽  
pp. 323-342 ◽  
Author(s):  
Janice Kaye Loudon ◽  
Byron Gajewski ◽  
Heather L. Goist-Foley ◽  
Karen Lee Loudon
Keyword(s):  
Physical Therapy ◽  
Outcome Measures ◽  
Statistical Difference ◽  
Weight Bearing ◽  
Exercise Program ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Home Exercise ◽  
Analog Scale

Objective:To determine the effect of exercise on patients with patellofemoral-pain syndrome (PFPS).Patients:29 subjects with unilateral PFPS, assigned to control, home-exercise (HE), or physical therapy (PT) group.Intervention:8-wk exercise program.Main Outcome Measures:A knee survey, visual analog scale (VAS), and 5 weight-bearing tests.Results:MANOVA indicated an overall statistical difference between groups (P< .05). The HE and PT groups experienced less pain than control, and PT experienced less pain than HE (P< .05). In overall knee function and most weight-bearing tests, HE and PT were stronger and more functional than control (P< .05). For anteromedial lunge only PT was stronger and more functional than control (P< .05).Conclusions:Intervention helps PFPS, but there appear to be no differences between home and in-clinic interventions.

scholarly journals REVIEW: PATELLOFEMORAL PAIN SYNDROME

2021 ◽  
Vol 9 (06) ◽  
pp. 324-331
Author(s):  
Pratigya Deuja ◽  
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Femoral Condyle ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Q Angle ◽  
Hip Abduction ◽  
Patellofemoral Contact Pressure ◽  
Rotation Strength

Patellofemoral pain syndrome is a common musculoskeletal condition and a major cause for anterior knee pain. It has been associated with excessive compression between the patella and the lateral femoral condyle. It is one of those overuse disorder that can limit activity of daily living along with participation in sports. The prevalence is more on female than those of male with the ratio of 2:1 and it affect athletic female more solely due to greater internal rotation of femur during running which leads to greater hip adduction. The reason for patellofemoral pain syndrome have been multifactorial increased femoral internal rotation, decreased hip abduction and external rotation strength, decreased VMO function and lateral retinaculum tightness. These factor leads to increase in dynamic Q angle that directly increases patellofemoral contact pressure which map a way to patellofemoral pain syndrome. The literature will have an explanation about altered hip kinetics, kinematics and its association with patellofemoral pain syndrome along with rehab protocol for patients with the same condition.

scholarly journals Reliability of a New Portable Dynamometer for Assessing Hip and Lower Limb Strength

2021 ◽  
Vol 11 (8) ◽  
pp. 3391
Author(s):  
Jan Marušič ◽  
Goran Marković ◽  
Nejc Šarabon
Keyword(s):  
Lower Limb ◽  
External Rotation ◽  
Peak Torque ◽  
Knee Extension ◽  
Lower Limb Muscles ◽  
Lower Limb Strength ◽  
Flexion Extension ◽  
Strength Tests ◽  
Hip Abduction ◽  
Maximal Peak

The purpose of this study was to evaluate intra- and inter-session reliability of the new, portable, and externally fixated dynamometer called MuscleBoard® for assessing the strength of hip and lower limb muscles. Hip abduction, adduction, flexion, extension, internal and external rotation, knee extension, ankle plantarflexion, and Nordic hamstring exercise strength were measured in three sessions (three sets of three repetitions for each test) on 24 healthy and recreationally active participants. Average and maximal value of normalized peak torque (Nm/kg) from three repetitions in each set and agonist:antagonist ratios (%) were statistically analyzed; the coefficient of variation and intra-class correlation coefficient (ICC2,k) were calculated to assess absolute and relative reliability, respectively. Overall, the results display high to excellent intra- and inter-session reliability with low to acceptable within-individual variation for average and maximal peak torques in all bilateral strength tests, while the reliability of unilateral strength tests was moderate to good. Our findings indicate that using the MuscleBoard® dynamometer can be a reliable device for assessing and monitoring bilateral and certain unilateral hip and lower limb muscle strength, while some unilateral strength tests require some refinement and more extensive familiarization.

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