Variations in Foot Posture and Mobility Between Individuals with Patellofemoral Pain and Those in a Control Group

2011 ◽  
Vol 101 (4) ◽  
pp. 289-296 ◽  
Author(s):  
Thomas G. McPoil ◽  
Meghan Warren ◽  
Bill Vicenzino ◽  
Mark W. Cornwall
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Control Group ◽  
Arch Height ◽  
Mean Values ◽  
Foot Posture ◽  
Foot Mobility

Background: We sought to determine whether foot posture and foot mobility were increased in individuals with patellofemoral pain syndrome compared with individuals in a control group. Methods: A nested case-control design was used with two controls matched to each patient by sex and age (±1 year). Participants included 43 individuals with a history of unilateral or bilateral patellofemoral pain syndrome and 86 participants in a control group. Data collected included height, weight, and five different measures of foot height and width in weightbearing and nonweightbearing that have been previously shown to have high levels of reliability. Results: Individuals with patellofemoral pain syndrome were found to be four times more likely (odds ratio, 4.04; 95% confidence interval, 1.45–11.32) to have a larger-than-normal difference between nonweightbearing and weightbearing arch height compared with those in the control group. The mean values for difference in arch height and foot mobility magnitude were also statistically significant between the patient and control groups. Foot posture, as determined using the arch height ratio, was not significant between groups (odds ratio, 0.94; 95% confidence interval, 0.34–2.61). Conclusions: Although foot posture may not be different between individuals with patellofemoral pain syndrome and controls, foot mobility assessed using difference in arch height and foot mobility magnitude is different between the two groups. (J Am Podiatr Med Assoc 101(4): 289–296, 2011)

Decreased Pulsatile Blood Flow in the Patella in Patellofemoral Pain Syndrome

2007 ◽  
Vol 35 (10) ◽  
pp. 1668-1673 ◽  
Author(s):  
Jan Näslund ◽  
Markus Walden ◽  
Lars-Göran Lindberg
Keyword(s):  
Blood Flow ◽  
Confidence Interval ◽  
Knee Flexion ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Control Group ◽  
Systematic Change ◽  
Pulsatile Blood Flow ◽  
Level Of Evidence

Background Anterior knee pain without clinical and radiologic abnormalities has primarily been explained from a purely structural view. A recently proposed biologic and homeostatic explanation questions the malalignment theory. No objective measurement of the pathophysiology responsible for changes in local homeostasis has been presented. Hypothesis Flexing the knee joint interferes with the perfusion of the patellar bone in patellofemoral pain syndrome. Study Design Case control study; Level of evidence, 4. Methods Pulsatile blood flow in the patella was measured continuously and noninvasively using photoplethysmography. Measurements were made with the patient in a resting position with knee flexion of 20° and after passive knee flexion to 90°. In total, 22 patients with patellofemoral pain syndrome were examined bilaterally, and 33 subjects with healthy knees served as controls. Results The pulsatile blood flow in the patient group decreased after passive knee flexion from 20° to 90° (systematic change in position, or relative position [RP] = —0.32; 95% confidence interval for RP, —0.48 to —0.17), while the response in the control group showed no distinct pattern (RP = 0.17; 95% confidence interval for RP, —0.05 to 0.31). The difference between the groups was significant (P = .0002). The median change in patients was —26% (interquartile range, 37). Conclusions Pulsatile patellar blood flow in patellofemoral pain syndrome patients is markedly reduced when the knee is being flexed, which supports the previous notion of an ischemic mechanism involved in the pathogenesis of this pain syndrome.

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.

Association between patellofemoral pain syndrome and hip morphology.

2015 ◽  
Vol 13 ◽  
pp. 291
Author(s):  
Hugo Machado Sanchez ◽  
Eliane Gouveia de Morais Sanchez ◽  
Savana Brandão Nascimento
Keyword(s):  
Morphological Changes ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Lower Limbs ◽  
Control Group ◽  
Hip Morphology ◽  
Prevalence Of Pain ◽  
Unclear Etiology ◽  
And Control

Background: Patellofemoral pain syndrome (PFPS) is one of the most common conditions in the knee joint, there still unclear etiology. Objective: The objective of this study was to investigate the association of PFPS with the morphology of the hip. Method/Design: For this study were evaluated 41 university students aged between 18 and 30 years divided into group with PFPS and control group, in which we analyzed the distance from the anterior superior iliac spine (ASIS), length of the lower limbs (LL) away from the patella ASIS bilaterally, lateral bending and iliac slope. Results: After data collection and subsequent tabulation, it was found that the group with PFPS showed contralateral iliac increase the pain (p = 0.01), moreover, was also found to the side of prevalence of pain is the side not dominant (p = 0.00). Conclusions: It can be inferred that there is little relationship between the morphological changes of the hip with the PFPS, as only found a side tilt of the pelvis in volunteer group that reported a previous knee pain.

Patellofemoral Pain Syndrome and Its Association with Hip, Ankle, and Foot Function in 16- to 18-Year-Old High School Students

2011 ◽  
Vol 101 (3) ◽  
pp. 215-222 ◽  
Author(s):  
Carsten Mølgaard ◽  
Michael Skovdal Rathleff ◽  
Ole Simonsen
Keyword(s):  
High School ◽  
High School Students ◽  
Knee Pain ◽  
Pain Syndrome ◽  
Patellofemoral Pain ◽  
Control Group ◽  
School Students ◽  
Navicular Drop ◽  
Foot Posture ◽  
Hip Rotation

Background: An increased pronated foot posture is believed to contribute to patellofemoral pain syndrome (PFPS), but the relationship between these phenomena is still controversial. The objectives of this study were to investigate the prevalence of PFPS in high school students and to compare passive internal and external hip rotation, passive dorsiflexion, and navicular drop and drift between healthy high school students and students with PFPS. Methods: All 16- to 18-year-old students in a Danish high school were invited to join this single-blind case-control study (N = 299). All of the students received a questionnaire regarding knee pain. The main outcome measurements were prevalence of PFPS, navicular drop and drift, passive ankle dorsiflexion, passive hip rotation in the prone position, and activity level. The case group consisted of all students with PFPS. From the same population, a randomly chosen control group was formed. Results: The prevalence of knee pain was 25%. Of the 24 students with knee pain, 13 were diagnosed as having PFPS. This corresponds to a PFPS prevalence of 6%. Mean navicular drop and drift were higher in the PFPS group versus the control group (navicular drop: 4.2 mm [95% confidence interval (CI), 3.2–5.3 mm] versus 2.9 mm [95% CI, 2.5–3.3 mm]; and navicular drift: 2.6 mm [95% CI, 1.6–3.7 mm] versus 1.4 mm [95% CI, 0.9–2.0 mm]). Higher passive ankle dorsiflexion was also identified in the PFPS group (22.2° [95% CI, 18°–26°] versus 17.7° [95% CI, 15°–20°]). Conclusions: This study demonstrated greater navicular drop, navicular drift, and dorsiflexion in high school students with PFPS compared with healthy students and highlights that foot posture is important to consider as a factor where patients with PFPS diverge from healthy individuals. (J Am Podiatr Med Assoc 101(3): 215–222, 2011)

Neuromuscular deficits in young women with patellofemoral pain syndrome compared to a control group

2014 ◽  
Vol 15 (2) ◽  
pp. e1-e2
Author(s):  
Camile Ludovico Zamboti ◽  
Rubens Alexandre da Silva ◽  
Cynthia Gobbi ◽  
Leonardo Shigaki ◽  
Diogo Paschualeto ◽  
...  
Keyword(s):  
Young Women ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Control Group

scholarly journals The Effects of 12-Weeks of Sensorimotor Exercise on Pain, Strength, Pelvic Drop, and Dynamic Knee Valgus in Males With Patellofemoral Pain Syndrome

2020 ◽  
Vol 10 (3) ◽  
pp. 159-168
Author(s):  
Ali Yalfani ◽  
◽  
Mohamadreza Ahmadi ◽  
Farzaneh Gandomi ◽  
◽  
...  
Keyword(s):  
Muscle Strength ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Quadriceps Muscle ◽  
Patellofemoral Pain ◽  
Control Group ◽  
Knee Valgus ◽  
Quadriceps Muscle Strength ◽  
Hip Abductor ◽  
Experimental Group

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.

Differences in Sonographic Characteristics of the Vastus Medialis Obliquus between Patients with Patellofemoral Pain Syndrome and Healthy Adults

2009 ◽  
Vol 37 (9) ◽  
pp. 1743-1749 ◽  
Author(s):  
Mei-Hwa Jan ◽  
Da-Hon Lin ◽  
Jiu-Jenq Lin ◽  
Chien-Ho Janice Lin ◽  
Cheng-Kung Cheng ◽  
...  
Keyword(s):  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Healthy Adults ◽  
Control Group ◽  
Vastus Medialis ◽  
Healthy Controls ◽  
Vastus Medialis Obliquus ◽  
Fiber Angle ◽  
Significant Difference

Background There is controversy regarding the relationship between patellofemoral pain syndrome (PFPS) and insufficiency of the vastus medialis obliquus (VMO). The conventional clinical practice of VMO strengthening for PFPS has been challenged for lack of evidence. The purpose of this study was to observe the difference in sonographic findings of the VMO between patients with PFPS and healthy adults. Hypothesis The morphological characteristics of the VMO are different between patients with PFPS and healthy adults. Study Design Case-control study; Level of evidence, 3. Methods Fifty-four patients with PFPS and 54 age-, gender-, body height—, and body weight—matched healthy adults as controls were enrolled in the study to measure by sonography the insertion level, fiber angle, and volume of the VMO at its insertional portion to detect differences between patients with PFPS and healthy controls. Results The insertion level, fiber angle, and VMO volume were all significantly smaller in the PFPS group than in the control group (P < .05). Multivariate analysis of variance has revealed a Wilks λ value of .845 and an F value of 5.640 (P = .001). Conclusion There was a significant difference in the 3 VMO measures between patients with PFPS and the healthy controls. Individuals might be predisposed to PFPS by different VMO characteristics, including insertion level and fiber angle. The current study cannot determine whether the observed morphological differences were the results of atrophy in response to pain or if they represent dysplasia that was predisposed to pain development. The clinical manifestations of VMO characteristics should be thoroughly investigated in other populations. Clinical Relevance The function of the VMO is important to consider in the rehabilitation of patients with PFPS.

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.

scholarly journals Surplus Value of Hip Adduction in Leg-Press Exercise in Patients With Patellofemoral Pain Syndrome: A Randomized Controlled Trial

2009 ◽  
Vol 89 (5) ◽  
pp. 409-418 ◽  
Author(s):  
Chen-Yi Song ◽  
Yeong-Fwu Lin ◽  
Tung-Ching Wei ◽  
Da-Hon Lin ◽  
Tzu-Yu Yen ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Oblique Muscle ◽  
Control Group ◽  
Leg Press ◽  
Randomized Controlled ◽  
Scale Scores

BackgroundA common treatment for patients with patellofemoral pain syndrome (PFPS) is strength (force-generating capacity) training of the vastus medialis oblique muscle (VMO). Hip adduction in conjunction with knee extension is commonly used in clinical practice; however, evidence supporting the efficacy of this exercise is lacking.ObjectiveThe objective of this study was to determine the surplus effect of hip adduction on the VMO.DesignThis study was a randomized controlled trial.SettingThe study was conducted in a kinesiology laboratory.ParticipantsEighty-nine patients with PFPS participated.InterventionParticipants were randomly assigned to 1 of 3 groups: hip adduction combined with leg-press exercise (LPHA group), leg-press exercise only (LP group), or no exercise (control group). Training consisted of 3 weekly sessions for 8 weeks.MeasurementsRatings of worst pain as measured with a 100-mm visual analog scale (VAS-W), Lysholm scale scores, and measurements of VMO morphology (including cross-sectional area [CSA] and volume) were obtained before and after the intervention.ResultsSignificant improvements in VAS-W ratings, Lysholm scale scores, and VMO CSA and volume were observed after the intervention in both exercise groups, but not in the control group. Significantly greater improvements for VAS-W ratings, Lysholm scale scores, and VMO volume were apparent in the LP group compared with the control group. There were no differences between the LP and LPHA groups for any measures.LimitationsOnly the VMO was examined by ultrasonography. The resistance level for hip adduction and the length of intervention period may have been inadequate to induce a training effect.ConclusionsSimilar changes in pain reduction, functional improvement, and VMO hypertrophy were observed in both exercise groups. Incorporating hip adduction with leg-press exercise had no impact on outcome in patients with PFPS.

scholarly journals Dose atrophy of vastus medialis obliquus and vastus lateralis exist in patients with patellofemoral pain syndrome

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Conglei Dong ◽  
Ming Li ◽  
Kuo Hao ◽  
Chao Zhao ◽  
Kang Piao ◽  
...  
Keyword(s):  
Vastus Lateralis ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Control Group ◽  
Vastus Lateralis Muscle ◽  
Vastus Medialis ◽  
Muscle Area ◽  
Vastus Medialis Obliquus ◽  
Lateralis Muscle

Abstract Background Whether vastus medialis obliquus atrophy exists in patients with patellofemoral pain syndrome and whether the amount of atrophy differs between the vastus medialis obliquus and vastus lateralis muscles remain unknown. Materials From June 2016 to March 2019, 61 patients with patellofemoral pain syndrome were retrospectively included in the study group, and an age-, sex-, and body mass index-matched cohort of 61 patients with normal knees was randomly selected as the control group. All enrolled subjects had undergone CT scans in the supine position. The cross-sectional areas of the vastus medialis obliquus and the vastus lateralis muscle in the sections 0, 5, 10, 15, and 20 mm above the upper pole of the patella were measured, and the vastus medialis obliquus/vastus lateralis muscle area ratio was evaluated. Results In the study group, the vastus medialis obliquus areas and the vastus lateralis muscle areas in the sections that were 0, 5, 10, 15, and 20 mm above the upper pole of the patella were significantly smaller than the respective areas in the control group (P < 0.05). The vastus medialis obliquus/vastus lateralis muscle area ratio was significantly smaller at the upper pole of the patella (the section 0 mm above the upper pole of the patella) than the corresponding ratio in the control group (P < 0.05). No significant difference was noted between the two groups in the sections 5, 10, 15, and 20 mm above the upper pole of the patella (P > 0.05). Conclusion In patients with patellofemoral pain syndrome, vastus medialis obliquus and vastus lateralis muscle atrophy existed in sections 0–20 mm above the upper pole of the patella, compared with normal controls, and atrophy of the vastus medialis obliquus was more evident than that of the vastus lateralis muscle at the upper pole of the patella. These findings support the rationale for the use of general quadriceps exercise combined with vastus medialis obliquus strengthening exercise as part of the rehabilitation programme for the patients with patellofemoral pain syndrome.

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