scholarly journals THU0567 HIP ABDUCTORS STRENGTH AND TRUNK, PELVIS, HIP AND KNEE FRONTAL PLANE KINEMATICS ANALYSIS DURING SINGLE-LEG SQUAT IN INDIVIDUALS WITH AND WITHOUT PATELLOFEMORAL OSTEOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 525.2-525
Author(s):  
C. Carvalho ◽  
G. Keppe Pisani ◽  
A. Felipe Martinez ◽  
L. Mancini ◽  
F. Viadanna Serrão ◽  
...  

Background:Previous studies have observed that individuals with patellofemoral pain (PFP) have decreased hip abduction torque, as well as increased hip adduction and knee abduction during activities with uniltateral weight bearing1,2. Considering that, a significant number of patients with patellofemoral osteoarthritis (PFOA) have a previous history of PFP3, it is speculated that the mechanical causes of PFP and PFOA may be similar. However, although alterations in hip muscle strength and lower limb kinematics during various functional activities have been reported in patients with PFP, they have not been explored in subjects with PFOA.Objectives:The objectives of this study were to compare the hip eccentric abductors torque and the trunk, pelvis, hip, and knee frontal plane kinematics in subjects with and without PFOA isolated during the single-leg squat.Methods:This is a cross-sectional study. The volunteers were divided into two groups: control group (CG - healthy individuals) and PFOA group (PFOAG - individuals with PFOA grade II or III). Eccentric peak torque of the hip abductors was evaluated using an isokinetic dynamometer Biodex Multi-Joint System 3, at angular speed of 30°/s. Trunk, pelvis, hip and knee kinematics were recorded during the single-leg squat using a 6-camera, 3-dimensional motion-analysis system (Vicon Motion Systems, Nexus System 2.1.1 and 3D Motion Monitor). The t-test Student was used to compare the variables between the groups. The significance level was set at 5% for all analyses (p ≤ 0.05).Results:The CG was composed by 12 participants (41.7% women). PFOA had 9 participants (44.4% women). Age (p = 0.1), height (p = 0.9) and body mass (p = 0.2) showed homogeneity between groups. Regardind body mass index, the OAPFG showed higher values (p = 0.02). PFOAG showed greater increased hip adduction than CG (p = 0.05) (Table 1). However, there were no differences among groups for trunk lean, contralateral pelvic elevation and knee abduction (p > 0.05). PFOAG showed lower hip abductor torque compared with the CG (p = 0.006).Table 1– Values of joint angles during single-leg squatting and hip abductors torque (normalized by body mass) in PFOA and healthy individualsPFOAGCGpvalueContralateral trunk lean (°)4.7±1.34.8±1.10.94Contralateral pelvic elevation (°)1.4±1.22.6±1.00.45Hip adduction (°)14.9±2.28.9±1.60.05*Knee abduction (°)22.8±3.819.4±3.30.51Hip eccentric abdutor torque (Nm/kg·100)166.5±24.9204±27.70.006*PFOAG: patellofemoral osteoarthritis group; CG: control group *Statistical difference between groupsConclusion:PFOA individuals showed greater hip adduction and lower hip abductors torque than the CG. Thus, it is suggested that muscle weakness may excessively influence hip adduction. Hip adduction is the main component of the knee valgus in the frontal plane. So, excessive dynamic valgus results in an increase Q-angle and, consequently, an increase in the lateral forces acting on the patella, causing greater stress on the lateral patellofemoral joint, which may contribute to disease progression. Therefore, we suggest that the hip abductor strengthening should be considered when treating individuals with PFOA.References:[1]Nakagawa TH, Moriya ÉTU, Maciel CD, Serrão FV. Trunk, Pelvis, Hip, and Knee Kinematics, Hip Strength, and Gluteal Muscle Activation During a Single-Leg Squat in Males and Females With and Without Patellofemoral Pain Syndrome.J Orthop Sport Phys Ther. 2012;42(6):491-501.[2]Nakagawa TH, Moriya ÉTU, Maciel CD, Serrão FV. Frontal Plane Biomechanics in Males and Females with and without Patellofemoral Pain.Med Sci Sport Exerc. 2012;44(9):1747-1755.[3]Utting MR, Davies G, Newman JH. Is anterior knee pain a predisposing factor to patellofemoral osteoarthritis?Knee. 2005;12(5):362-365.Acknowledgments:São Paulo Research Foundation (FAPESP) (Grant/Award Numbers: 2017/20057-8; 2017/25959-0; 2018/10329-3).Disclosure of Interests:None declared

2017 ◽  
Vol 32 (2) ◽  
pp. 179-190 ◽  
Author(s):  
Gretchen B Salsich ◽  
Barbara Yemm ◽  
Karen Steger-May ◽  
Catherine E Lang ◽  
Linda R Van Dillen

Objective: To investigate whether a novel, task-specific training intervention that focused on correcting pain-producing movement patterns was feasible and whether it would improve hip and knee kinematics, pain, and function in women with patellofemoral pain. Design: Prospective, non-randomized, within-group, double baseline, feasibility intervention study. Subjects: A total of 25 women with patellofemoral pain were enrolled. Intervention: The intervention, delivered 2×/week for six weeks, consisted of supervised, high-repetition practice of daily weight-bearing and recreational activities. Activities were selected and progressed based on participants’ interest and ability to maintain optimal alignment without increasing pain. Main measures: Primary feasibility outcomes were recruitment, retention, adherence, and treatment credibility (Credibility/Expectancy Questionnaire). Secondary outcomes assessing intervention effects were hip and knee kinematics, pain (visual analog scale: current, average in past week, maximum in past week), and function (Patient-Specific Functional Scale). Results: A total of 25 participants were recruited and 23 were retained (92% retention). Self-reported average daily adherence was 79% and participants were able to perform their prescribed home program correctly (reduced hip and knee frontal plane angles) by the second intervention visit. On average, treatment credibility was rated 25 (out of 27) and expectancy was rated 22 (out of 27). Hip and knee kinematics, pain, and function improved following the intervention when compared to the control phase. Conclusion: Based on the feasibility outcomes and preliminary intervention effects, this task-specific training intervention warrants further investigation and should be evaluated in a larger, randomized clinical trial.


2020 ◽  
Vol 44 ◽  
pp. 121-127
Author(s):  
Theresa H. Nakagawa ◽  
Ana F. dos Santos ◽  
Giovanna C. Lessi ◽  
Rafael S. Petersen ◽  
Rodrigo Scattone Silva

2016 ◽  
Vol 06 (01) ◽  
pp. 068-073
Author(s):  
Kavitha Shetty ◽  
Lawrence Mathias ◽  
Mahesh V. Hegde ◽  
Sukumar Shanmugam

Abstract Purpose: To investigate the influence of additional eccentric strengthening to the hip abductor and lateral rotator musculature on pain and function in sedentary people with Patellofemoral pain syndrome (PFPS). Methods: 30 sedentary patients between 18 and 40 years of age, with a diagnosis of PFPS, all the subjects received treatment for a period of 4weeks and the subjects were randomly assigned to Control group (CG) and Experimental group (EG). The patients in the Control group (n = 15) performed a conventional knee-stretching and strengthening program, whereas, patients in the Experimental group (n = 15) performed the same exercises as those in the control group ,in addition received eccentric strengthening exercises for the hip abductors and lateral rotators. An 11-point numeric pain rating scale (NPRS), the Lower Extremity Functional Scale (LEFS) and the Anterior Knee Pain Scale (AKPS) were used as outcome measures during the baseline and at the end of 4weeks . Results: Statistics were retrieved using SPSS.16, paired 't' test was conducted to compare AKPS and LEFS values ,whereas, Mann- Whitney U test was used for NPRS value between the groups. After 4 weeks of treatment, the control group, pre and post-test value for AKPS (p<0.001),LEFS (P<0.001),NPRS (p<0.001) shows a statistical significance and even in the experimental group, pre and post-test value for AKPS (p<0.001),LEFS (P<0.001),NPRS (p<0.001) shows a statistical significance in pain and function, but comparing both the group experimental group is significantly more better AKPS (p=0.002),LEFS (P<0.001),NPRS (P<0.001) then a control group. Conclusion: short term Knee strengthening exercises supplemented by eccentric hip abductor and lateral rotator musculature–strengthening exercises were more effective than knee exercises alone in improving function and reducing pain in sedentary people with PFPS.


2021 ◽  
Vol 3 (1) ◽  
pp. 195-204
Author(s):  
Pezhman Masoudi ◽  
◽  
Soheil Mansour Sohani ◽  
Ali Amiri ◽  
◽  
...  

Background and Objectives: Patellofemoral Arthropathy (PFA) is the most common knee disorder in runners and various factors can lead to the development of its symptoms. It has been proposed that frontal plane motions of the hip and knee can raise the dynamic quadriceps angle during functional tasks. The aim of this study was to evaluate frontal plane acting hip muscle flexibility and strength differences in male sprinter runners with unilateral PFA. Methods: A total of 38 male runners complaining of peripatellar pain or showing positive unilateral patellar grind test, assigned to the normal and sound legs, and 20 matched control groups were compared in this case-control study. Participants’ hip abductor and adductor muscles strength and their flexibility were evaluated through a hand-held dynamometer and 2D motion analysis tracker software. To measure the strength, participants were positioned side-lying position, performing abduction and adduction, while a dynamometer was placed on the lateral and medial femoral epicondyle. Active and passive abduction and adduction range of motion were recorded via a camera in the supine position and the film was analyzed by the software. Results: Abductor muscle strength and abduction-to-adduction ratio on the involved side were significantly lower than the uninvolved side (P=0.029, P=0.008, d=-0.388, d=-0.459), while greater adduction and lower abduction to adduction ratio were found in the control group (P<0.001, F=3.599). Also, lesser passive abduction and active adduction range of motion were found in the control group on both sides (P<0.001, F=2.792, F=8.979). Conclusion: Strength changes of the involved side compared with uninvolved side and less flexible side, but more probably inhibited and stronger adductors in the control group may suggest impaired muscular interaction based on frontal plane muscles torque/length curve function in unilateral PFA. Changes in the strength of the involved side compared to the healthy side and the adductor muscles with more flexibility and strength but more inhibited by the abductor’s muscles in the control group could indicate.


2020 ◽  
Vol 10 (3) ◽  
pp. 159-168
Author(s):  
Ali Yalfani ◽  
◽  
Mohamadreza Ahmadi ◽  
Farzaneh Gandomi ◽  
◽  
...  

Purpose: Patellofemoral Pain Syndrome (PFPS) is among the most prevalent complaints observed in healthcare clinics. This group of patients encounters Pelvic Drop (PD) and Dynamic Knee Valgus (DNV); its’ causes have been reported as pain and decreased muscle strength. The current study aimed to explore the effects of a 12-week Sensorimotor Exercise (SME) on pain, strength, PD, and DNV in males with PFPS. Methods: This randomized double-blind clinical trial involved 32 patients with PFPS. The study samples were randomly divided into the experimental (n=16) and control (n=16) groups. To assess pain, the Visual Analogue Scale (VAS) was used. Moreover, quadriceps muscle strength was measured by the hip abductor hand dynamometer. To analyze PD and DNV, camera and Kinova software were used during stairs descent. The experimental group performed 12 weeks of SME for 3 one-hour weekly sessions. However, the control group received no therapeutic intervention during this time. The obtained data were analyzed in SPSS using Analysis of Covariance (ANCOVA).  Results: The data analysis results suggested that pain significantly reduced in the experimental group, compared to the control group, after twelve weeks of SME (P<0.001). Besides, quadriceps muscle strength (P<0.002) and hip abductor muscle strength (P<0.001) improved, and PD angle (P<0.002) and DNV (P<0.003) were reduced. Conclusion: SME reduced pain and facilitated the frequency and time of muscle activation. It also increased the strength of the gluteus medius muscle as the main stabilizer of the pelvis chain and led to a reduction in PD and DNV. Thus, SME could be used as a comprehensive protocol treatment to improve various disorders in patients with PFPS.


2020 ◽  
pp. 2050016
Author(s):  
Leonardo Intelangelo ◽  
Diego Bordachar ◽  
Cristian Mendoza ◽  
Nicolás Bevacqua ◽  
Alexandre Carvalho Barbosa

Background: Chronic nonspecific low back pain (CNSLBP) is the leading cause of long-term pain and disability. There is evidence suggesting a relationship between CNSLBP in adult women and altered hip kinematics and gluteus medius (GM) muscle function. However, this association has been less studied in young women. Objective: To assess the association between lower limb and pelvis kinematics in the frontal plane, and GM strength and electromyographic activity in young women with CNSLBP compared with an age-matched control group of asymptomatic women. Methods: In this cross-sectional study, 32 young women with CNSLBP ([Formula: see text] months of pain; Oswestry index range: 21–40%) and 20 healthy age-matched women were included. The frontal plane projection angle (FPPA) and contralateral pelvis drop (CPD) at the endpoint of the single-leg squat (SLS) test were measured through photogrammetry. Mean GM muscle activity during the SLS and peak isometric GM strength was measured using surface electromyography (sEMG) and hand-held dynamometry, respectively. Results: The Hotelling’s trace showed no significant differences between groups when the variables were considered as a composite ([Formula: see text]; [Formula: see text]). Also, the univariate results showed no individual differences between groups considering each variable separately. Conclusions: The results showed no association between CNSLBP, hip and pelvis kinematics, and GM strength and activity in young women.


2016 ◽  
Vol 22 (2) ◽  
pp. 66-69
Author(s):  
Veronika S. Pshennova ◽  
O. V Aleksandrov

The article presents the results of study demonstrating that though evident symptoms of pulmonary hypertension were absent (maximal systolic tension was within standards both in males and females of main group) reliable increasing of blood pressure in pulmonary artery in comparison with control group under increasing of body mass index, waist volume and index waist/hips. At that, in males of main group under obesity degree I and II average blood pressure exceeded limits of standards.


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