The effects of increased forward trunk lean during stair ascent on hip adduction and internal rotation in asymptomatic females

Hip-focused strengthening and task-specific movement training for an individual with chronic, recurrent femoroacetabular impingement syndrome

OBJECTIVES

Examine the effects of hip-focused strengthening and task-specific movement training for a female who has undergone multiple surgical procedures yet continues to experience chronic, recurrent FAIS-related symptoms.

STUDY DESIGN

Case Report.

METHODS

A 23-year-old active female with an eleven-year history of FAIS and two previous surgical procedures recently experienced a third recurrence of symptoms brought on by increased physical activity levels. The patient performed progressive exercises focused on improving hip extension, abduction, and external rotation strength. The patient also received task-specific movement training aimed at minimizing hip adduction and internal rotation during movement that provoked her symptoms.

RESULTS

Following treatment, the patient's self-reported hip pain during movement improved 2.2 points and was abolished during four of the five activities examined. The patient exhibited strength gains for the hip extensors (22 %), abductors (36 %), and external rotators (20 %). The patient exhibited decreased hip adduction during all activities (mean difference = 10.6°) and decreased hip internal rotation during three of the five activities (mean difference = 3.7°).

CONCLUSION

This case report highlights the effects of hip-focused strengthening and task-specific movement training for a patient with longstanding FAIS and multiple surgical procedures.

The influence of pain exacerbation on rear foot eversion and plantar pressure symmetry in women with patellofemoral pain: a cross sectional study

BACKGROUND

The patellofemoral joint (PFJ) stress as a primary mechanical stimulus in the patellofemoral pain (PFP) etiology is affected by plantar pressure symmetry. This study evaluated how pain exacerbation affects rear foot eversion and plantar pressure distribution symmetry.

METHOD

Sixty women with PFP participated in this study. Pain intensity, rear foot eversion, and plantar pressure were evaluated in the two conditions with and without pain exacerbation during double-leg squats. The MANOVA test was used to compare pain intensity, rear foot eversion, and plantar pressure symmetry between the two conditions. The Pearson correlation was used to evaluate the relationship between the pain intensity with the rear foot eversion and the plantar pressure symmetry.

RESULTS

The comparison between the two conditions showed a significant difference in pain intensity (P < 0.001, η2 = 0.623), rear foot eversion (P < 0.001, η2 = 0.485), plantar pressure distribution symmetry of the right-left foot (P < 0.001, η2 = 0.438), forefoot and rear-foot of the right foot (P < 0.001, η2 = 0.607), and forefoot and rear-foot of the left foot (P < 0.001, η2 = 0.548). An excellent correlation was observed between the pain intensity with rear foot eversion (P < 0.001, r = 0.835) and plantar pressure distribution symmetry of the right-left foot (P < 0.001, r = 0.812), forefoot and rear-foot of the right foot (P < 0.001, r = 0.834), and forefoot and rear-foot of the left foot (P < 0.001, r = 0.811).

CONCLUSIONS

After the pain exacerbation, the rear foot eversion was greater, and plantar pressure asymmetrical was observed, which can help in the development of PFP severity.

Sex and body height influences on patellofemoral joint reaction force during stair ascent

BACKGROUND

Females are at greater risk of developing patellofemoral pain (PFP) than males, and an excessive patellofemoral joint reaction force (PFJRF) may contribute to this discrepancy. It is unknown if the PFJRF differs between males and females during stair ascent. Additionally, body height may also influence the PFJRF. This study investigated PFJRF differences between males and females and explored relationships between body height and PFJRF during stair ascent.

METHODS

Thirty males (25.6 (2.7) yr) and thirty females (23.7 (2.2) yr) ascended stairs (96 steps/min). Three-dimensional kinematics (200 Hz) and kinetics (2000 Hz) were recorded and used to calculate biomechanical dependent variables.

RESULTS

Females experienced a greater PFJRF magnitude (mean difference (MD) = 3.2 N/kg; 95% CI = 0.5, 5.9; p = 0.022) and rate (MD = 23.8 N/kg/sec; 95% CI = 2.7, 45.1; p = 0.029), quadriceps muscle force (3.1 N/kg; 95% CI = 0.2, 6.0; p = 0.036), and knee flexion angle (MD = 2.3°; 95% CI = 0.3, 4.3; p = 0.026). Females exhibited shorter quadriceps lever arm length (MD = -0.1 cm; 95% CI = -0.2, 0.0; p = 0.024) and body height (MD = -16.9 cm; 95% CI = -20.5, -13.2, p < 0.001) compared to males. Body height was inversely correlated with PFJRF magnitude (r = -0.31; p = 0.017), rate (r = -0.28; p = 0.032), and knee flexion angle (r = -0.54; p < 0.001).

CONCLUSION

Females experienced a greater PFJRF than males. Additionally, the PFJRF and body height were inversely correlated. This observed difference may contribute to the PFP sex discrepancy and be due, at least in part, to body height differences.

The Effects of Increasing Trunk Flexion During Stair Ascent on the Rate and Magnitude of Achilles Tendon Force in Asymptomatic Females

Research indicates that increasing trunk flexion may optimize patellofemoral joint loading. However, this postural change could cause an excessive Achilles tendon force (ATF) and injury risk during movement. This study aimed to examine the effects of increasing trunk flexion during stair ascent on ATF, ankle biomechanics, and vertical ground reaction force in females. Twenty asymptomatic females (age: 23.4 [2.5] y; height: 1.6 [0.8] m; mass: 63.0 [12.2] kg) ascended stairs using their self-selected and flexed trunk postures. Compared with the self-selected trunk condition, decreases were observed for peak ATF (mean differences [MD] = 0.14 N/kg; 95% confidence interval [CI], 0.06 to 0.23; Cohen d = -1.2; P = .003), average rate of ATF development (MD = 0.25 N/kg/s; 95% CI, 0.07 to 0.43; Cohen d = -0.9; P = .010), ankle plantar flexion moment (MD = 0.08 N·m/kg; 95% CI, 0.03 to 0.13; Cohen d = -1.1; P = .005), and vertical ground reaction force (MD = 38.6 N/kg; 95% CI, 20.3 to 56.90; Cohen d = -1.8; P < .001). Increasing trunk flexion did not increase ATF. Instead, this postural change was associated with a decreased ATF rate and magnitude and may benefit individuals with painful Achilles tendinopathy.