IMMEDIATE EFFECTS OF SEMI-CUSTOM INSOLES AND STRUCTURED KNEE SLEEVES ON LOWER EXTREMITY KINETICS AND KINEMATICS IN RECREATIONAL MALE ATHLETES WITH PATELLOFEMORAL PAIN

2021 ◽  
Author(s):  
JONATHAN KENNETH SINCLAIR ◽  
BOBBIE BUTTERS
Keyword(s):  
Three Dimensional ◽  
Patellofemoral Pain ◽  
Knee Adduction Moment ◽  
Psychological Wellbeing ◽  
Male Athletes ◽  
Recreational Athletes ◽  
Peak Knee ◽  
Pain Subscale ◽  
Load Rate ◽  
Pain Symptoms

The aim of this experiment was to provide insight into the immediate influence of both semi-custom insoles and knee sleeves in recreational male runners/athletes suffering from patellofemoral pain and also to explore the association between the extent of patellofemoral pain and psychological wellbeing. Experiment 1 examined 17 male recreational runners with patellofemoral pain, in semi-custom insole and no-insole conditions. Experiment 2 examined 13 male recreational athletes with patellofemoral pain, undertaking run, [Formula: see text] cut and single-leg hop movements in knee sleeve and no-sleeve conditions. In both experiments, motion capture and ground reaction forces were collected, allowing kinetics and three-dimensional kinematics to be calculated alongside patellofemoral joint loading quantified using musculoskeletal modeling. In both experiments, patellofemoral pain symptoms were examined using the KOOS patellofemoral pain subscale and psychological wellbeing using the COOP-WONCA questionnaire. The findings from both experiments showed that pain symptoms significantly predicted psychological wellbeing ([Formula: see text] in experiment 1 and [Formula: see text] in experiment 2). Experiment 1 showed that orthoses significantly reduced tibial internal rotation range of motion (no-[Formula: see text] and [Formula: see text]) whilst also increasing the peak knee adduction moment (no-[Formula: see text][Formula: see text]N[Formula: see text]m/kg and [Formula: see text][Formula: see text]N[Formula: see text]m/kg). The findings from experiment 2 revealed that the knee sleeve reduced the peak patellofemoral force (no-[Formula: see text][Formula: see text]BW and [Formula: see text][Formula: see text]BW) in the run movement and the patellofemoral load rate in the cut movement (no-[Formula: see text][Formula: see text]BW/s and [Formula: see text][Formula: see text]BW/s). Overall, the findings confirm that pain symptoms are predictive of psychological wellbeing in recreational male athletes with patellofemoral pain. Furthermore, the findings suggest that both insoles and knee sleeves may provide immediate biomechanical benefits in recreationally active individuals with patellofemoral pain, although when wearing insoles this may be at the expense of an increased knee adduction moment during running.

scholarly journals Effect of Laterally Wedged Foot Orthoses on Rearfoot and Hip Mechanics in Patients with Medial Knee Osteoarthritis

2009 ◽  
Vol 33 (2) ◽  
pp. 107-116 ◽  
Author(s):  
Robert J. Butler ◽  
Joaquin A. Barrios ◽  
Todd Royer ◽  
Irene S. Davis
Keyword(s):  
Knee Osteoarthritis ◽  
Three Dimensional ◽  
Frontal Plane ◽  
Knee Adduction Moment ◽  
Orthotic Devices ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Peak Knee ◽  
Wedge Condition ◽  
Foot Orthotic

The purpose of this study was to examine the effects of laterally wedged foot orthotic devices, used to treat knee osteoarthritis, on frontal plane mechanics at the rearfoot and hip during walking. Thirty individuals with diagnosed medial knee osteoarthritis were recruited for this study. Three dimensional kinematics and kinetics were recorded as the subjects walked in the laboratory at an intentional walking speed. Peak eversion, eversion excursion and peak eversion moment were increased while the peak knee adduction moment was reduced in the laterally wedged orthotic condition compared to the no wedge condition. In contrast, no changes were observed in the variables of interest at the hip. There was no significant relationship between the change in the peak frontal plane moment at the rearfoot and change in the peak frontal plane moment at the knee or hip as a result of the lateral wedge. Laterally wedged foot orthotic devices, used to treat knee osteoarthritis, do not influence hip mechanics. However, they do result in increased rearfoot eversion and inversion moment. Therefore, a full medical screen of the foot should occur before laterally wedged foot orthotic devices are prescribed as a treatment for knee osteoarthritis.

Is Two-Dimensional Video A Valid And Reliable Measure Of Three-Dimensional Kinematics In Runners With Patellofemoral Pain?

2019 ◽  
Vol 26 (6) ◽  
pp. 9-9
Author(s):  
Bradley Stephen Neal ◽  
Simon David Lack ◽  
Christian John Barton ◽  
Alexandra Birn-Jeffrey ◽  
Stuart Miller ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Knee Flexion ◽  
Three Dimensional ◽  
Patellofemoral Pain ◽  
Two Dimensional ◽  
Poor Agreement ◽  
Rater Reliability ◽  
Peak Knee ◽  
Clinical Gait Analysis ◽  
Hip Internal Rotation

Background/Aims Peak hip adduction and knee flexion during running are associated with patellofemoral pain persistence, representing treatment targets. Clinical practice is lacking a validated, reliable tool with which to measure these kinematics. This study aimed to determine the accuracy of clinical gait analysis, by investigating concurrent validity, intra- and inter-rater reliability of two-dimensional video. Methods A total of 21 participants with patellofemoral pain were recruited (10 males, 11 females). Synchronised three-dimensional and two-dimensional kinematic data were collected during over-groundrunning. Two-dimensional videos were analysed with the Hudl Technique application using a commercially available tablet (iPad). Single measure intraclass coreelation coefficients (ICCs) were calculated using a two-way mixed effects model with absolute agreement. Three-dimensional peak hip internal rotation was investigated as a covariate with backward linear regression, using the F change statistic. Results There was poor agreement between three-dimensional and two-dimensional measurement of peak hip adduction (ICC 0.06) and peak knee flexion (ICC 0.42). Moderate intra-rater reliability was identified for both variables (ICC 0.61–0.65). Inter-rater reliability for peak knee flexion was moderate (ICC 0.71), but was poor for peak hip adduction (ICC 0.31). Three-dimensional peak hip internal rotation did not significantly explain the identified poor agreement for either variable. Conclusions Poor agreement between three-dimensional kinematics and two-dimensional video was identified for both variables in runners with patellofemoral pain, despite acceptable intra-rater reliability. Investigation of software with increased precision is warranted, to improve the accuracy of two-dimensional video predicting three-dimensional kinematics in the clinical setting. Clinical gait analysis using the Hudl Technique application is not currently advocated.

scholarly journals Acute Effects of Barefoot And Minimalist Footwear on Medial Tibiofemoral Compartment Loading During Running: A Statistical Parametric Mapping Approach

2018 ◽  
Vol 65 (1) ◽  
pp. 35-44 ◽  
Author(s):  
Jonathan Sinclair ◽  
Bobbie Butters ◽  
Philip Stainton
Keyword(s):  
Repeated Measures ◽  
Stance Phase ◽  
Three Dimensional ◽  
Statistical Parametric Mapping ◽  
Medial Compartment ◽  
Knee Adduction Moment ◽  
Camera System ◽  
Parametric Mapping ◽  
Increased Risk ◽  
Load Rate

Abstract The current investigation examined the effects of running barefoot and in minimalist footwear on medial tibiofemoral compartment loading, compared to conventional running trainers. Fifteen male runners ran over a force platform in five different footwear conditions (barefoot, Vibram five-fingers (Footwear A), Inov-8 (Footwear B) Nike-Free (Footwear C), and running trainer) whilst lower extremity kinematics were examined using a three-dimensional camera system. Medial compartment loading during the stance phase was explored using the knee adduction moment (KAM). In addition, the KAM instantaneous load rate was also calculated. Differences between footwear across the entire stance phase were examined using 1-dimensional statistical parametric mapping, whereas differences in discrete parameters were explored using one-way repeated measures ANOVA. Statistical parametric mapping revealed that Footwear B was associated with a significantly larger KAM compared to the running trainer from 15-20 and 25-30% of the stance phase and also Footwear C from 15-20% of the stance phase. The KAM instantaneous load rate was significantly larger in the barefoot (210.69 Nm/kg/s), Footwear A (200.23 Nm/kg/s) and Footwear B (186.03 Nm/kg/s) conditions in comparison to Footwear C (100.88 Nm/kg/s) and running trainers (92.70 Nm/kg/s). The findings from this study indicate that running barefoot and in minimalist footwear with the least midsole interface may place runners at increased risk of medial compartment knee OA, although further exploration using habitual barefoot / minimalist footwear users is required.

scholarly journals Knee joint kinetics in response to multiple three-dimensional printed, customised foot orthoses for the treatment of medial compartment knee osteoarthritis

2017 ◽  
Vol 231 (6) ◽  
pp. 487-498 ◽  
Author(s):  
Richard Allan ◽  
James Woodburn ◽  
Scott Telfer ◽  
Mandy Abbott ◽  
Martijn PM Steultjens
Keyword(s):  
Knee Flexion ◽  
Significant Interaction ◽  
Three Dimensional ◽  
Knee Adduction Moment ◽  
Foot Orthoses ◽  
Peak Knee ◽  
Biomechanical Response ◽  
Flexion Moment ◽  
Foot Orthosis ◽  
Second Peak

The knee adduction moment is consistently used as a surrogate measure of medial compartment loading. Foot orthoses are designed to reduce knee adduction moment via lateral wedging. The ‘dose’ of wedging required to optimally unload the affected compartment is unknown and variable between individuals. This study explores a personalised approach via three-dimensional printed foot orthotics to assess the biomechanical response when two design variables are altered: orthotic length and lateral wedging. Foot orthoses were created for 10 individuals with symptomatic medial knee osteoarthritis and 10 controls. Computer-aided design software was used to design four full and four three-quarter-length foot orthoses per participant each with lateral posting of 0° ‘neutral’, 5° rearfoot, 10° rearfoot and 5° forefoot/10° rearfoot. Three-dimensional printers were used to manufacture all foot orthoses. Three-dimensional gait analyses were performed and selected knee kinetics were analysed: first peak knee adduction moment, second peak knee adduction moment, first knee flexion moment and knee adduction moment impulse. Full-length foot orthoses provided greater reductions in first peak knee adduction moment (p = 0.038), second peak knee adduction moment (p = 0.018) and knee adduction moment impulse (p = 0.022) compared to three-quarter-length foot orthoses. Dose effect of lateral wedging was found for first peak knee adduction moment (p < 0.001), second peak knee adduction moment (p < 0.001) and knee adduction moment impulse (p < 0.001) indicating greater unloading for higher wedging angles. Significant interaction effects were found for foot orthosis length and participant group in second peak knee adduction moment (p = 0.028) and knee adduction moment impulse (p = 0.036). Significant interaction effects were found between orthotic length and wedging condition for second peak knee adduction moment (p = 0.002). No significant changes in first knee flexion moment were found. Individual heterogeneous responses to foot orthosis conditions were observed for first peak knee adduction moment, second peak knee adduction moment and knee adduction moment impulse. Biomechanical response is highly variable with personalised foot orthoses. Findings indicate that the tailoring of a personalised intervention could provide an additional benefit over standard interventions and that a three-dimensional printing approach to foot orthosis manufacturing is a viable alternative to the standard methods.

scholarly journals Analysis of 3-D Kinematics Using H-Gait System during Walking on a Lower Body Positive Pressure Treadmill

Sensors ◽  
2021 ◽  
Vol 21 (8) ◽  
pp. 2619
Author(s):  
Yoshiaki Kataoka ◽  
Ryo Takeda ◽  
Shigeru Tadano ◽  
Tomoya Ishida ◽  
Yuki Saito ◽  
...  
Keyword(s):  
Motion Analysis ◽  
Wearable Sensors ◽  
Three Dimensional ◽  
Lower Limbs ◽  
Positive Pressure ◽  
Lower Body ◽  
Lower Body Positive Pressure ◽  
Gait Kinematics ◽  
Peak Knee ◽  
Body Positive

Recently, treadmills equipped with a lower-body positive-pressure (LBPP) device have been developed to provide precise body weight support (BWS) during walking. Since lower limbs are covered in a waist-high chamber of an LBPP treadmill, a conventional motion analysis using an optical method is impossible to evaluate gait kinematics on LBPP. We have developed a wearable-sensor-based three-dimensional motion analysis system, H-Gait. The purpose of the present study was to investigate the effects of BWS by a LBPP treadmill on gait kinematics using an H-Gait system. Twenty-five healthy subjects walked at 2.5 km/h on a LBPP treadmill under the following three conditions: (1) 0%BWS, (2) 25%BWS and (3) 50%BWS conditions. Acceleration and angular velocity from seven wearable sensors were used to analyze lower limb kinematics during walking. BWS significantly decreased peak angles of hip adduction, knee adduction and ankle dorsiflexion. In particular, the peak knee adduction angle at the 50%BWS significantly decreased compared to at the 25%BWS (p = 0.012) or 0%BWS (p < 0.001). The present study showed that H-Gait system can detect the changes in gait kinematics in response to BWS by a LBPP treadmill and provided a useful clinical application of the H-Gait system to walking exercises.

Depression and Anxiety as Mediators of PTSD Symptom Clusters and Pain in Treatment-Seeking Canadian Forces Members and Veterans

2021 ◽  
Author(s):  
Maya Roth ◽  
Lisa King ◽  
Don Richardson
Keyword(s):  
Symptom Severity ◽  
Ptsd Symptom ◽  
Symptom Clusters ◽  
Anxiety And Depression ◽  
Generalized Anxiety ◽  
Sf 36 ◽  
Pain Subscale ◽  
Psychiatric Conditions ◽  
Pain Symptoms ◽  
The Relationship

ABSTRACT Introduction Chronic pain (CP) commonly presents alongside psychiatric conditions such as depression, PTSD, and generalized anxiety. The current study sought to better understand this complex relationship by determining whether anxiety and depression symptom severity mediated the relationship between DSM-5 PTSD symptom clusters and pain symptoms in a sample of 663 Canadian Armed Forces (CAF) personnel and veterans seeking treatment for mental health conditions. Materials and Methods Generalized anxiety disorder, depression, and PTSD symptom severity were measured using self-report scales provided as part of a standard intake protocol. Pain symptoms were measured using the Bodily Pain subscale of the SF-36 (SF-36 BPS). Linear regressions were used to explore the relationship between PTSD symptom clusters, depression, anxiety, and pain. Bootstrapped resampling analyses were employed to test mediation effects. Results The average SF-36 BPS score in this sample was 36.6, nearly 1.5 SDs below the population health status, enforcing the salience of pain symptoms as a concern for veterans and CAF seeking treatment for military-related psychiatric conditions. The effects of PTSD symptom clusters avoidance, negative mood and cognitions, and arousal on pain were fully mediated by anxiety and depression severity. However, the effect of intrusion on pain was not mediated by depression and only partly mediated by anxiety. Conclusion Findings emphasize the importance of including anxiety and depression in models of PTSD and pain, particularly in samples where psychiatric comorbidity is high. Clinically, results highlight the need for improved treatment regimens that address pain symptoms alongside common psychiatric comorbidities.

scholarly journals Effects of a Prophylactic Knee Sleeve on Anterior Cruciate Ligament Loading During Sport-Specific Movements

2019 ◽  
Vol 28 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Jonathan Sinclair ◽  
Paul J. Taylor
Keyword(s):  
Anterior Cruciate Ligament ◽  
Repeated Measures ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Musculoskeletal Modeling ◽  
Acl Injuries ◽  
Recreational Athletes ◽  
Load Rate ◽  
Anterior Cruciate ◽  
3D Motion Capture

Context: Prophylactic knee bracing is extensively utilized in athletic populations to reduce the high risk from knee injuries, but its role in the attenuation of anterior cruciate ligament (ACL) pathologies is not well understood. Objective: The aim of this investigation was to explore the effects of a prophylactic knee sleeve on ACL loading parameters linked to the etiology of injury in recreational athletes. Setting: Laboratory. Design: Repeated measures. Participants: Thirteen healthy male recreational athletes. Intervention: Participants performed run, cut, and single-leg hop movements under 2 conditions; prophylactic knee sleeve and no sleeve. Main Outcome Measures: Biomechanical data were captured using an 8-camera 3D motion capture system and a force platform. Peak ACL force, average ACL load rate, and instantaneous ACL load rate were quantified using a musculoskeletal modeling approach. Results: The results showed that both average and instantaneous ACL load rates were significantly reduced when wearing the knee sleeve in the hop (sleeve = 612.45/1286.39 N/kg/s and no sleeve = 743.91/1471.42 N/kg/s) and cut (sleeve = 222.55/1058.02 N/kg/s and no sleeve = 377.38/1183.01 N/kg/s) movements. Conclusions: Given the biomechanical association between ACL loading and the etiology of ACL injuries, it is proposed that athletes may be able to attenuate their risk from injury during cut and hop movements through utilization of a prophylactic knee sleeve.

scholarly journals Patellar Maltracking Persists in Adolescent Females With Patellofemoral Pain

2017 ◽  
Vol 5 (2) ◽  
pp. 232596711668677 ◽  
Author(s):  
Victor R. Carlson ◽  
Barry P. Boden ◽  
Aricia Shen ◽  
Jennifer N. Jackson ◽  
Katharine E. Alter ◽  
...  
Keyword(s):  
Natural History ◽  
Pain Score ◽  
Three Dimensional ◽  
Patellofemoral Pain ◽  
Adolescent Females ◽  
Physical Activities ◽  
Symptom Improvement ◽  
Patellar Maltracking ◽  
History Of

Background: Patellofemoral pain is one of the most common conditions seen in sports medicine practices, particularly among adolescent females. However, the natural history of the underlying pathology in patellofemoral pain during puberty remains poorly understood. Purpose: The purpose of this longitudinal study is to assess changes in patellar maltracking patterns in subjects with patellofemoral pain as they mature from mid- to late adolescence. Study Design: Cohort study; Level of evidence, 3. Methods: Three-dimensional patellofemoral kinematic data were acquired during active knee extension-flexion using dynamic magnetic resonance imaging in 6 girls (10 knees; mean age, 14.0 years) with clinically diagnosed patellofemoral pain. The subjects then returned as late adolescents (mean age, 18.5 years) for follow-up scanning. Three-dimensional patellofemoral kinematic parameters were evaluated across the range of motion, but comparison between time points was restricted to 10° of flexion. Participation in impact and nonimpact physical activities, pain score based on the visual analog scale, and the anterior knee pain score were also compared across initial and follow-up visits. Results: All subjects reported improved patellofemoral pain symptoms at follow-up, and one subject reported complete resolution. However, relative to the initial visit, no differences were found in patellar maltracking. There was a decrease in hours engaged in impact physical activities for all subjects at follow-up. Conclusion: This study provides insight into the natural history of patellofemoral pain in adolescent females. The relatively unchanged patellofemoral maltracking across subjects suggests that potential anatomic and kinematic abnormalities contributing to patellofemoral pain during mid-adolescence persist during skeletal maturation. Symptom improvement for these subjects did not result from a change in patellofemoral tracking, but rather from other causes.

Musculoskeletal Problems In The Female Athlete

2018 ◽  
Author(s):  
Irfan M Asif ◽  
Kimberly Harmon ◽  
Mallory Shasteen
Keyword(s):  
Female Athlete ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Adhesive Capsulitis ◽  
Treatment Options ◽  
Patellofemoral Pain ◽  
Male Athletes ◽  
Anterior Cruciate Ligament Injuries ◽  
Musculoskeletal Problems ◽  
Anterior Cruciate

Musculoskeletal injuries in the female athlete are, for the most part, similar to those in the male athlete. However, there are differences in the incidence of these injuries and in the sports in which they tend to occur. Female athletes have a higher rate of noncontact anterior cruciate ligament injuries than male athletes. Other musculoskeletal problems are also more common in females, such as multidirectional instability of the shoulder, adhesive capsulitis, and patellofemoral pain. This review addresses injuries that are seen commonly in female athletes and outlines current diagnosis and treatment options. This review contains 3 figures and 32 references Key words: ACL tear, adhesive capsulitis, atraumatic, female athlete, injection, knee, patellofemoral pain, shoulder

Musculoskeletal Problems in the Female Athlete

2018 ◽  
Author(s):  
Irfan M Asif ◽  
Emily Edwards ◽  
Kimberly Harmon
Keyword(s):  
Female Athlete ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Adhesive Capsulitis ◽  
Treatment Options ◽  
Patellofemoral Pain ◽  
Male Athletes ◽  
Anterior Cruciate Ligament Injuries ◽  
Musculoskeletal Problems ◽  
Anterior Cruciate

Musculoskeletal injuries in the female athlete are, for the most part, similar to those in the male athlete. However, there are differences in the incidence of these injuries and in the sports in which they tend to occur. Female athletes have a higher rate of noncontact anterior cruciate ligament injuries than male athletes. Other musculoskeletal problems are also more common in females, such as multidirectional instability of the shoulder, adhesive capsulitis, and patellofemoral pain. This review addresses injuries that are seen commonly in female athletes and outlines current diagnosis and treatment options. This review contains 3 figures and 32 references Key words: ACL tear, adhesive capsulitis, atraumatic, female athlete, injection, knee, patellofemoral pain, shoulder

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