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Yalfani A, Ahadi F, Ahmadi M, Asgarpoor A. Relationship between exacerbating patellofemoral pain and dynamic knee valgus in females with patellofemoral pain after a patellofemoral joint loading protocol: A cross-sectional. Phys Ther Sport 2024; 67:13-18. [PMID: 38428188 DOI: 10.1016/j.ptsp.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE The aim of the present study is to 1) the effect of exacerbating patellofemoral pain (PFP) on dynamic knee valgus (DKV) 2) the relationship between exacerbating PFP and DKV in females with patellofemoral pain. DESIGN Cross-sectional study. METHODS Sixty women with PFP were recruited from the orthopedic clinics. We evaluated pain intensity and DKV in two conditions without (condition 1) and with (condition 2) PFJ loading during the single-leg squat (SLS) task. The MANOVA test was used to compare pain intensity and DKV angle between the two conditions. Furthermore, the Pearson correlation was used to examine the correlation between pain intensity with DKV angle. RESULTS The MANOVA analysis showed that pain intensity (P < 0.000, η2 = 0.623) and DKV angle (P < 0.000, η2 = 0.544) with a medium effect size significantly increased after PFJ loading. Furthermore, an excellent positive correlation was observed between an increase in pain intensity and DKV angle (P < 0.000, r = 0.840). CONCLUSION It seems that after the PFJ loading protocol and the subsequent pain exacerbation, the neuromuscular biomechanics of the lower limb are deficits. As a result, the stabilizing muscles activation decreases and increases the lower limb movement in the frontal plane.
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Affiliation(s)
- Ali Yalfani
- Professor, Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, Bu-ali Sina University, Hamedan, Iran.
| | - Fatemeh Ahadi
- Professor, Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, Bu-ali Sina University, Hamedan, Iran.
| | - Mohamadreza Ahmadi
- Professor, Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, Bu-ali Sina University, Hamedan, Iran.
| | - Azadeh Asgarpoor
- Professor, Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, Bu-ali Sina University, Hamedan, Iran.
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Bathe C, Fennen L, Heering T, Greif A, Dubbeldam R. Training interventions to reduce the risk of injury to the lower extremity joints during landing movements in adult athletes: a systematic review and meta-analysis. BMJ Open Sport Exerc Med 2023; 9:e001508. [PMID: 37304892 PMCID: PMC10254820 DOI: 10.1136/bmjsem-2022-001508] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2023] [Indexed: 06/13/2023] Open
Abstract
Objective Aim of this systematic review was to summarise training interventions designed to reduce biomechanical risk factors associated with increased risk of lower extremity landing injuries and to evaluate their practical implications in amateur sports. Design Systematic review and meta-analysis. Data sources MEDLINE, Scopus and SPORTDiscus. Eligibility criteria Training intervention(s) aimed at reducing biomechanical risk factors and/or injury rates included the following: (1) prospective or (non-)randomised controlled study design; (2) risk factors that were measured with valid two-dimensional or three-dimensional motion analysis systems or Landing Error Scoring System during jump landings. In addition, meta-analyses were performed, and the risk of bias was assessed. Results Thirty-one studies met all inclusion criteria, capturing 11 different training interventions (eg, feedback and plyometrics) and 974 participants. A significantly medium effect of technique training (both instruction and feedback) and dynamic strengthening (ie, plyometrics with/without strengthening) on knee flexion angle (g=0.77; 95% CI 0.33 to 1.21) was shown. Only one-third of the studies had training interventions that required minimal training setup and additional coaching educations. Conclusion This systematic review highlights that amateur coaches can decrease relevant biomechanical risk factors by means of minimal training setup, for example, instructing to focus on a soft landing, even within only one training session of simple technique training. The meta-analysis emphasises implementing technique training as stand-alone or combined with dynamic strengthening into amateur sport training routine.
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Affiliation(s)
- Chantal Bathe
- Movement Science, Westfälische Wilhelms University Münster, Münster, Germany
| | - Lena Fennen
- Movement Science, Westfälische Wilhelms University Münster, Münster, Germany
| | - Theresa Heering
- Coventry University, Coventry, UK
- Deakin University School of Health and Social Development, Melbourne, Victoria, Australia
| | - Alexander Greif
- Movement Science, Westfälische Wilhelms University Münster, Münster, Germany
| | - Rosemary Dubbeldam
- Movement Science, Westfälische Wilhelms University Münster, Münster, Germany
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Association of Proximal and Distal Factors With Lower Limb Kinematics During a Classical Ballet Jump. J Sport Rehabil 2023; 32:170-176. [PMID: 36049748 DOI: 10.1123/jsr.2021-0256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 07/08/2022] [Accepted: 07/18/2022] [Indexed: 02/07/2023]
Abstract
CONTEXT Excessive dynamic lower limb misalignment may predispose ballet dancers to jump-related injuries. However, it is unknown whether proximal and distal factors influence this movement pattern. The aim of this study was to investigate whether hip abduction strength, foot alignment, and ankle dorsiflexion range of motion (ROM) are associated with peak angles of hip adduction and internal rotation and knee abduction during the preparation and landing phases of a classical ballet jump. DESIGN Cross-sectional study. METHODS Forty-one healthy amateur ballet dancers were included. Hip abduction strength was evaluated isometrically using a handheld dynamometer, foot alignment was determined by the shank-forefoot alignment, and weight-bearing ankle dorsiflexion ROM was measured by performing the lunge test. Peak hip and knee angles were analyzed 3-dimensionally during the preparation and landing phases of a single-leg jump. A Pearson correlation matrix was used to investigate the association of hip abduction strength, shank-forefoot alignment, and ankle dorsiflexion ROM with peak angles of hip adduction and internal rotation and knee abduction during the preparation and landing phases of the jump. RESULTS Greater hip abduction strength was associated with greater peak hip internal rotation angle (r = .43, P < .05), but not with peak hip adduction and knee abduction angles during the preparation phase of the jump. There were no associations of shank-forefoot alignment and ankle dorsiflexion ROM with peak hip and knee angles during the preparation (r = -.23 to .36, P > .05) and landing (r = -.20 to .24, P > .05) phases of the jump. There was no association of hip abduction strength with peak hip and knee angles during the landing phase of the jump (r = -.28 to .16, P > .05). CONCLUSION Hip abductors strengthening, correction of foot misalignments, and increasing ankle dorsiflexion ROM may not prevent excessive hip and knee movements during a classical ballet single-leg jump in amateur dancers.
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Frontal plane projection angle predicts patellofemoral pain: Prospective study in male military cadets. Phys Ther Sport 2023; 59:73-79. [PMID: 36525739 DOI: 10.1016/j.ptsp.2022.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Patellofemoral pain (PFP) is a major source of knee pain. Identifying who may develop PFP is of paramount importance. PURPOSE To assess whether Frontal plane projection angles (FPPA) and hand held dynamometry (HHD) strength measures can predict development of PFP. STUDY DESIGN Prospective evaluation of individuals undertaking a military training programme. METHODS Male military recruits were enrolled and prospectively followed up from enrolment to completion of 12-weeks training. Lower limb kinematics (FPPA, Q-angle, hip adduction angle, knee flexion, ankle dorsiflexion, and rearfoot eversion angle) measured during running, single leg squatting (SLS), and single leg landing (SLL) and isometric muscle strength of hip abductors and knee extensors. RESULTS Body mass, hip abductor muscle strength, Q-angle during SLS and SLL, FPPA during SLL all significantly different between the PFP and non-injured groups and predicted PFP, highest predictor variable was FPPA during SLL (Odds Ratio = 1.13, P = 0.01). A FPPA≥5.2° during SLL predicting PFP with a sensitivity of 70% and a specificity of 70%. CONCLUSION Participants who developed PFP had a number of physical factors significantly different than the non-injured group, most predictive was a larger FPPA during SLL, with angles greater than 5.2° associated with a 2.2x greater risk. CLINICAL RELEVANCE Assessing FPPA during SLL could be used to determine who was predisposed to PFP.
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Are Physical Function and Fear of Movement Risk Factors for Patellofemoral Pain? A 2-Year Prospective Study. J Sport Rehabil 2023; 32:24-30. [PMID: 35894902 DOI: 10.1123/jsr.2021-0392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 05/02/2022] [Accepted: 05/11/2022] [Indexed: 01/03/2023]
Abstract
CONTEXT To determine (1) whether physical function and fear of movement are prospectively associated with the risk of females developing patellofemoral pain (PFP) and (2) whether they change following development of PFP. DESIGN Prospective observational study. METHODS A total of 114 asymptomatic females (18-22 y old) completed assessment of physical function (forward step-down test and single-leg hop for distance) and fear of movement using the Tampa Scale for Kinesiophobia at baseline and 2-year follow-up. Presence of symptoms of PFP was monitored bimonthly. RESULTS Ninety participants (retention rate = 79%) completed the 2-year follow-up assessment, with 27 (24% of the cohort) developing PFP. Physical function, including forward step-down test (P = .659) and single-leg hop for distance (P = .825), and fear of movement (P = .479) were not associated with the risk of developing PFP. Females who developed PFP presented with reduced forward step-down repetitions (mean difference = 2.8; 95% confidence interval, 0.2 to 5.3) and single-leg hop for distance (10.2; 95% confidence interval, 2.7 to 17.7 cm) at 2-year follow-up. There was no statistically significant difference between those who did and did not develop PFP for fear of movement (-3.4; 95% confidence interval, -7.0 to 0.2). CONCLUSIONS Physical function and fear of movement were not associated with the risk of developing PFP in young females. However, the change over time in the step-down and single-leg hop for distance tests may suggest that, even in the early stages of PFP, young females present impaired physical function compared with females who did not develop symptoms. Fear of movement may develop due to persistent PFP, and does not appear to be a risk factor or key feature in females with PFP of short symptoms duration.
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Harsted S, Holsgaard-Larsen A, Hestbæk L, Andreasen DL, Lauridsen HH. Test-retest reliability and agreement of lower-extremity kinematics captured in squatting and jumping preschool children using markerless motion capture technology. Front Digit Health 2022; 4:1027647. [PMID: 36544465 PMCID: PMC9760710 DOI: 10.3389/fdgth.2022.1027647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
The clinimetric properties of new technology should be evaluated in relevant populations before its implementation in research or clinical practice. Markerless motion capture is a new digital technology that allows for data collection in young children without some drawbacks commonly encountered with traditional systems. However, important properties, such as test-retest reliability, of this new technology have so far not been investigated. We recorded 63 preschool children using markerless motion capture (The Captury GmbH, Saarbrüken, Germany) while they performed squats and standing broad jumps. A retest session was conducted after 1 week. Recordings from the test session were processed twice to estimate the software-driven instrumental variability. Recordings from the first and second test sessions were compared to evaluate the week-to-week test-retest reliability. Statistical tests included 95% limits of agreement and intraclass correlations of absolute agreement (ICC). Jump length performance and four kinematic variables demonstrated acceptable instrumental variability (ICC > 0.76). The week-to-week reliability was excellent for jump length performance (ICC = 0.90) but poor to moderate (ICC < 0.55) for the kinematic variables. Our results indicate that preschool children exhibit considerable intra-individual kinematic variation from week-to-week during jump landings and squats. Consequently, we suggest that future work should explore individuals with persistent extreme kinematics over multiple test-sessions.
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Affiliation(s)
- Steen Harsted
- Research Unit for Clinical Biomechanics, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark,Correspondence: Steen Harsted
| | - Anders Holsgaard-Larsen
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lise Hestbæk
- Research Unit for Clinical Biomechanics, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark,Chiropractic Knowledge Hub, University of Southern Denmark, Odense, Denmark
| | - Ditte Lundsgaard Andreasen
- Research Unit for Clinical Biomechanics, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Henrik Hein Lauridsen
- Research Unit for Clinical Biomechanics, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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ElMelhat AM, Shalash KA, Chabara AEA, Azzam AH, Mohamed NA. Identifying female responders to proximal control exercises in patellofemoral pain syndrome: A clinical prediction rule. J Taibah Univ Med Sci 2022; 17:954-961. [PMID: 36212592 PMCID: PMC9519603 DOI: 10.1016/j.jtumed.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/13/2022] [Accepted: 05/14/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Ahmed M. ElMelhat
- Department of Physical Therapy for Musculoskeletal Disorders and Their Surgeries, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- Corresponding address: Department of Physical Therapy for Musculoskeletal Disorders and Their Surgeries, Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
| | - Khaled A. Shalash
- Department of Physical Therapy for Musculoskeletal Disorders and Their Surgeries, El-Salam University, Egypt
| | - Abd Elrahman A. Chabara
- Department of Physical Therapy for Musculoskeletal Disorders and Their Surgeries, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Ahmad H. Azzam
- Department of Orthopedic Surgery, Faculty of Medicine, Cairo University, Egypt
| | - Nabil A. Mohamed
- Department of Physical Therapy for Musculoskeletal Disorders and Their Surgeries, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
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DeJong Lempke AF, Collins SE, Whitney KE, D'Hemecourt PA, Meehan WP. A Comparison of Factors Associated with Running-Related Injuries between Adult and Adolescent Runners. Int J Sports Phys Ther 2022; 17:1033-1042. [PMID: 36237652 PMCID: PMC9528711 DOI: 10.26603/001c.38045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 06/27/2022] [Indexed: 11/18/2022] Open
Abstract
Background There are multiple personal and environmental factors that influence the risk of developing running-related injuries (RRIs). However, it is unclear how these key clinical factors differ between adult and adolescent runners. Purpose The purpose of this study was to compare anthropometric, training, and self-reported outcomes among adult and adolescent runners with and without lower extremity musculoskeletal RRIs. Study Design Cross-sectional study. Methods Questionnaire responses and clinical assessment data were extracted from 38 adult runners (F: 25, M: 13; median age: 23 [range 18-36]) and 91 adolescent runners (F: 56, M: 35; median age: 15 [range 14-16]) who underwent a physical injury prevention evaluation at a hospital-affiliated sports injury prevention center between 2013 and 2021. Participants were sub-grouped into those with (adults: 25; adolescents: 38) and those without (adults: 13; adolescents: 53) a history of self-reported RRIs based on questionnaire responses. Multivariate analyses of covariance (MANCOVA) covarying for gender were conducted to compare outcomes across groups. Results Adult runners had lower Functional Movement Screen™ (FMS™) scores (mean differences [MD]: -1.4, p=0.01), were more likely to report intentional weight-loss to improve athletic performance (% difference: 33.0%; p:<.001), and more frequently included resistance training into their training routines (% difference: 21.0%, p=0.01) compared to adolescents. Those with a history of RRIs were more likely to report intentional weight-loss compared to uninjured runners (% difference: 21.3; p=0.02) and had shorter single leg bridge durations than those without RRIs (RRI: 57.9±30, uninjured: 72.0±44, p=0.01). Conclusion The findings indicate that addressing aspects of biomechanics identified by the FMS™ and behaviors of weight loss as an effort to improve performance may represent targets for the prevention of RRIs for adult and adolescent runners, given the association with history of RRIs. Level of Evidence 3.
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Affiliation(s)
- Alexandra F DeJong Lempke
- School of Kinesiology, University of Michigan; Micheli Center for Sports Injury Prevention; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital
| | - Sara E Collins
- Micheli Center for Sports Injury Prevention; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital
| | - Kristin E Whitney
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital; Harvard Medical School
| | - Pierre A D'Hemecourt
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital; Harvard Medical School
| | - William P Meehan
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital; Harvard Medical School
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Bazett-Jones DM, Waiteman MC, Glaviano NR. Depth of single-leg squat influences the two-dimensional analysis of knee, hip, and pelvis frontal plane motion in pain-free women. Gait Posture 2022; 98:279-282. [PMID: 36219951 DOI: 10.1016/j.gaitpost.2022.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/15/2022] [Accepted: 10/02/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The single-leg squat (SLS) is often used to measure two-dimensional frontal plane motion; however, there is a variability in the SLS depth across studies. RESEARCH QUESTION Are knee abduction (KABD), hip adduction (HADD), pelvic drop (PD), and lateral trunk flexion (LTF) angles different at greater knee flexion angles during a SLS? METHODS Twenty pain-free females (age=22.3 ± 1.1 years, height=1.68 ± 0.06 m, mass=63.1 ± 11.7 kg) participated in this cross-sectional study. Participants performed five SLSs to the lowest depth comfortable, keeping pace with a metronome, while being video recorded in the frontal and sagittal planes. The middle three SLSs were used for analysis. KABD, HADD, PD, and LTF angles were measured at 30º, 45º, 60º, 75º, and 90º of knee flexion using extracted images. Linear mixed model analyses were used to compare across knee flexion angles and clinical significance was determined by comparing angle changes to the standard error of measurement (SEM). RESULTS We observed significant differences for KABD (F=14.69, p < .001), HADD (F=46.29, p < .001), and PD (F=27.27, p < .001) among knee flexion angles. Post-hoc analyses revealed that KABD significantly increased at every increase of knee flexion angle (p ≤ .05, d=0.54-1.95), as did HADD (p ≤ .05, d=0.64-3.85) and PD (p ≤ .05, d=0.61-3.03). Changes in KABD, HADD, and PD often exceeded SEM for all changes in knee flexion angles. SIGNIFICANCE Knee, hip, and pelvic frontal plane motions are influenced by knee flexion angles during 2D analysis of a SLS task. Our results highlight the importance of standardizing SLS depth during research and clinical practice to ensure appropriate comparisons across measurements.
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Affiliation(s)
- David M Bazett-Jones
- Department of Exercise and Rehabilitation Sciences, College of Health and Human Services, The University of Toledo, Toledo, OH, USA.
| | - Marina Cabral Waiteman
- Department of Exercise and Rehabilitation Sciences, College of Health and Human Services, The University of Toledo, Toledo, OH, USA; São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Neal R Glaviano
- Department of Kinesiology, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, CT, USA; Institute for Sports Medicine, University of Connecticut, Storrs, CT, USA
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Rhodes J, Tagawa A, McCoy A, Bazett-Jones D, Skinner A, Leveille L, Franklin C, Chafetz R, Tulchin-Francis K. Using Motion Analysis in the Evaluation, Treatment & Rehabilitation of Pediatric & Adolescent Knee Injuries: A Review of the Literature. Clin Sports Med 2022; 41:671-685. [DOI: 10.1016/j.csm.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Pompeo KD, da Rocha ES, Morales AB, Klein KD, Vaz MA. Does forward step-down task frontal kinematics differ in women with and without patellofemoral pain? A cross-sectional study. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-021-00869-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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de Vasconcelos DP, Aidar FJ, Lima TB, Filho FMDN, Mendonça ILA, Díaz-de-Durana AL, Garrido ND, Santiago MS, Junior WMDS. Assessment of Dynamic Knee Valgus between Lateral Step-Down Test and Running in Female Runners with and without Patellofemoral Pain Using Two-Dimensional Video Analysis. Clin Pract 2022; 12:425-435. [PMID: 35735666 PMCID: PMC9221657 DOI: 10.3390/clinpract12030047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/16/2022] Open
Abstract
Dynamic knee valgus (DKV) is a frontal plane knee kinematic alteration that has been associated with patellofemoral pain (PFP) in female runners. DKV is commonly assessed in clinical practice by measuring frontal plane knee projection angle (FPPA) during squat tests. However, it remains unclear whether the DKV observed in these tests is similar to or correlates with that observed during running in female runners. The aims of this cross-sectional study were to correlate and compare DKV, by measuring FPPA values, in a lateral step-down (LSD) squat test and running in female runners with and without PFP. A two-dimensional (2D) video analysis of the LSD test and running was carried out for 21 asymptomatic female runners and 17 PFP female runners in order to determine FPPA values. A Pearson correlation test and a factorial ANOVA with Bonferroni post hoc correction were used for statistical analysis. The FPPAs recorded in the LSD test were significantly higher than those recorded during running in the asymptomatic (16.32° ± 5.38 vs. 4.02° ± 3.26, p < 0.01) and PFP groups (17.54° ± 7.25 vs. 4.64° ± 3.62, p < 0.01). No significant differences were found in FPPA values between asymptomatic and PFP runners during the LSD test (16.32° ± 5.38 vs. 17.54° ± 7.25, p = 0.55) and running (4.02° ± 3.26 vs. 4.64° ± 3.62, p = 0.58). There was a small (r < 0.3) and non-significant (p > 0.05) correlation in FPPAs between the LSD test and running in both groups. According to our results, DKV was not similar during the LSD test and running, and there was no significant correlation in FPPA values between the LSD test and running in both groups. Therefore, clinicians and therapists should be aware of these findings when using the LSD test in clinical practice to evaluate DKV in female runners with or without PFP.
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Affiliation(s)
- Diego Protasio de Vasconcelos
- Postgraduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil;
- Musculoskeletal System Unit, University Hospital, Federal University of Sergipe (UFS), Aracaju 49060-025, Brazil;
- Correspondence: (D.P.d.V.); (F.J.A.)
| | - Felipe J. Aidar
- Postgraduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil;
- Correspondence: (D.P.d.V.); (F.J.A.)
| | - Tarcisio Brandao Lima
- Postgraduate Program of Health Sciences, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil; (T.B.L.); (F.M.d.N.F.)
| | | | | | - Alfonso López Díaz-de-Durana
- Sports Department, Physical Activity and Sports Faculty-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Nuno Domingos Garrido
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Trás-os-Montes e Alto Douro, 5001-801 Vila Real, Portugal;
| | - Michael Silveira Santiago
- Musculoskeletal System Unit, University Hospital, Federal University of Sergipe (UFS), Aracaju 49060-025, Brazil;
| | - Walderi Monteiro da Silva Junior
- Postgraduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil;
- Department of Physical Therapy, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil;
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Bird MB, Mi Q, Koltun KJ, Lovalekar M, Martin BJ, Fain A, Bannister A, Vera Cruz A, Doyle TLA, Nindl BC. Unsupervised Clustering Techniques Identify Movement Strategies in the Countermovement Jump Associated With Musculoskeletal Injury Risk During US Marine Corps Officer Candidates School. Front Physiol 2022; 13:868002. [PMID: 35634154 PMCID: PMC9132209 DOI: 10.3389/fphys.2022.868002] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/05/2022] [Indexed: 11/15/2022] Open
Abstract
Musculoskeletal injuries (MSKI) are a significant burden on the military healthcare system. Movement strategies, genetics, and fitness level have been identified as potential contributors to MSKI risk. Screening measures associated with MSKI risk are emerging, including novel technologies, such as markerless motion capture (mMoCap) and force plates (FP) and allow for field expedient measures in dynamic military settings. The aim of the current study was to evaluate movement strategies (i.e., describe variables) of the countermovement jump (CMJ) in Marine officer candidates (MOCs) via mMoCap and FP technology by clustering variables to create distinct movement strategies associated with MSKI sustained during Officer Candidates School (OCS). 728 MOCs were tested and 668 MOCs (Male MOCs = 547, Female MOCs = 121) were used for analysis. MOCs performed 3 maximal CMJs in a mMoCap space with FP embedded into the system. De-identified MSKI data was acquired from internal OCS reports for those who presented to the OCS Physical Therapy department for MSKI treatment during the 10 weeks of OCS training. Three distinct clusters were formed with variables relating to CMJ kinetics and kinematics from the mMoCap and FPs. Proportions of MOCs with a lower extremity and torso MSKI across clusters were significantly different (p < 0.001), with the high-risk cluster having the highest proportions (30.5%), followed by moderate-risk cluster (22.5%) and low-risk cluster (13.8%). Kinetics, including braking rate of force development (BRFD), braking net impulse and propulsive net impulse, were higher in low-risk cluster compared to the high-risk cluster (p < 0.001). Lesser degrees of flexion and shorter CMJ phase durations (braking phase and propulsive phase) were observed in low-risk cluster compared to both moderate-risk and high-risk clusters. Male MOCs were distributed equally across clusters while female MOCs were primarily distributed in the high-risk cluster. Movement strategies (i.e., clusters), as quantified by mMoCap and FPs, were successfully described with MOCs MSKI risk proportions between clusters. These results provide actionable thresholds of key performance indicators for practitioners to use for screening measures in classifying greater MSKI risk. These tools may add value in creating modifiable strength and conditioning training programs before or during military training.
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Affiliation(s)
- Matthew B. Bird
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, United States
- *Correspondence: Matthew B. Bird,
| | - Qi Mi
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kristen J. Koltun
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, United States
| | - Mita Lovalekar
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, United States
| | - Brian J. Martin
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, United States
| | - AuraLea Fain
- Biomechanics, Physical Performance and Exercise Research Group, Department of Health Sciences, Macquarie University, Sydney, NSW, Australia
| | | | | | - Tim L. A. Doyle
- Biomechanics, Physical Performance and Exercise Research Group, Department of Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Bradley C. Nindl
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, United States
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14
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Criterion Validity and Reliability of Knee Frontal Plane Projection Angles Measured Using the Technique Application. J Sport Rehabil 2022; 31:797-802. [PMID: 35361737 DOI: 10.1123/jsr.2021-0356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/28/2022] [Accepted: 02/07/2022] [Indexed: 11/18/2022]
Abstract
CONTEXT Abnormal knee frontal plane projection angles (FPPA) during movement have been associated with patellofemoral pain. As such, clinicians are interested in valid and reliable instruments suitable for broad-based clinical use that allow them to objectively measure such variables. Therefore, the purpose of the current study was to examine the criterion validity and reliability of knee FPPA measures obtained by clinicians using a free tablet application called Technique. DESIGN Validity/reliability study. METHODS To examine validity, the same raters measured 10, two-dimensional criterion reference angles at the first testing session. To examine reliability, the knee FPPA of 16 subjects was measured by 6 raters (3 physical therapists and 3 student physical therapists) on 2 separate occasions while performing a single-limb step-down task. Validity was investigated by calculating the 95% limits of agreement, mean absolute differences, and Bland-Altman plots. Reliability was examined by calculating intraclass correlation coefficients and the SE of measure. RESULTS For validity, the mean absolute difference between rater and criterion reference angle measures ranged from 0.20° to 0.90°. Ninety-five percent of expected errors between rater and criterion reference angle measures were 2.04° or less. For reliability, the intraclass correlation coefficient values for interrater and intrarater reliability were excellent ranging from .994 to .998 with SE of measure ranging from 0.44° to 0.84°. CONCLUSIONS These findings indicate that knee FPPA measures obtained during a single-limb step-down task using the Technique tablet application are valid and reliable, and suitable for clinical use.
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15
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Yang C, Best TM, Liu H, Yu B. Knee biomechanical factors associated with patellofemoral pain in recreational runners. Knee 2022; 35:87-97. [PMID: 35255371 DOI: 10.1016/j.knee.2022.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 11/06/2021] [Accepted: 02/07/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Patellofemoral pain (PFP) is a common injury among runners. Knee biomechanical factors associated with PFP, however, remain unclear. The purpose of this study was to determine possible associations between knee biomechanics and symptoms of PFP in recreational runners. METHODS Fifteen male and 15 female recreational runners with PFP were enrolled as the PFP group, 30 matched runners without PFP were recruited as the control group. The PFP group was tested running with and without knee pain, while the control group had only one running test. Reflective marker coordinates and ground reaction force data were collected in each test. Knee kinematics and kinetics during running were reduced and compared between groups (PFP group without knee pain and control group) and between pain conditions (PFP group with knee pain and without knee pain), as well as between sexes. RESULTS Female and male participants with PFP had an increased peak knee valgus angle when running without pain compared to matched controls (P = 0.001), and to themselves when running with pain (P = 0.001). Male participants with PFP also had an increased peak knee flexion angle when running without pain compared to matched controls (P = 0.008), however did not decrease their peak knee flexion angle when running with pain (P = 0.245). No significant main effect of group or pain condition on any peak knee joint moment during running was detected (P ≥ 0.175). CONCLUSIONS Increased peak knee valgus angle during running appears to be a critical biomechanical factor associated with PFP in recreational runners, while decreasing knee valgus angle during running may be an adaptation to reduce symptoms of PFP. Increased peak knee flexion angle during running appears to be another biomechanical factor associated with PFP that is sex specific for male recreational runners.
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Affiliation(s)
- Chen Yang
- School of Sports and Health, Nanjing Sport Institute, Nanjing 210014, China
| | - Thomas M Best
- UHealth Sports Medicine Institute, University of Miami, Miami, FL 33136, USA
| | - Hui Liu
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China.
| | - Bing Yu
- Center for Human Movement Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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16
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Theisen BJ, Larson PD, Chambers CC. Optimizing Rehabilitation and Return to Sport in Athletes With Anterior Knee Pain Using a Biomechanical Perspective. Arthrosc Sports Med Rehabil 2022; 4:e199-e207. [PMID: 35141552 PMCID: PMC8811520 DOI: 10.1016/j.asmr.2021.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/18/2021] [Indexed: 11/28/2022] Open
Abstract
Anterior knee pain represents one of the most common athletic knee conditions and arguably also one of the most complex. The patellofemoral joint is at the center of several forces, and alterations in any of these force vectors due to muscular imbalance, soft-tissue tightness or laxity, and altered functional movement patterns can all combine to create a painful anterior knee. While typically anterior knee pain is not a surgical entity, the orthopaedic surgeon with an understanding of these biomechanical intricacies is best positioned to provide comprehensive evidence-based care for the patient with anterior knee pain. Level of Evidence V, expert opinion.
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17
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Losciale J, Wayman K, Mansfield CJ, Rethman KK, Briggs MS. A preliminary analysis of physical therapist agreement regarding the perceived impairments in cases of runners with knee pain. Physiother Theory Pract 2021; 38:2938-2948. [PMID: 34315318 DOI: 10.1080/09593985.2021.1946876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background: There is a scarcity of evidence describing how physical therapists use data from clinical examinations to inform the treatment of runners with knee pain.Objective: Our purpose was to examine the between physical therapist agreement on the selection of perceived impairments in runners with knee pain.Methods: Twelve physical therapists reviewed two cases of runners with knee pain. The cases included clinical subjective information, objective data, and review of videos of each participant running. Each rater selected up to three perceived impairments (from a list of eight) that each physical therapist would address at the next physical therapy session. Percent agreement was calculated to determine the between rater agreement on each individual perceived impairment selection and Fleiss Kappa was calculated for each unique combination of three perceived impairments per case.Results: Twelve raters with 51 (18-156) months of clinical experience participated. Percent agreement ranged from 8%-100% for both cases for individual impairments. When assessing the unique combination of three impairments selected, inter-rater agreement was less than what is expected due to chance alone (κ = -0.09, p = .92; κ = -0.09, p = .98) for both cases.Conclusion: The 12 physical therapists demonstrated poor to excellent levels of agreement when selecting an individual perceived impairment. Agreement was worse than chance when selecting a combination of three unique impairments.
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Affiliation(s)
- Justin Losciale
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Katherine Wayman
- Jameson Crane Sports Medicine Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Cody J Mansfield
- Jameson Crane Sports Medicine Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA.,Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Jameson Crane Sports Medicine Institute, Columbus, OH, USA.,School of Health and Rehabilitation Sciences, College of Medicine, Ohio State University, Columbus, OH, USA.,Ambulatory Rehabilitation, Ohio State Sports Medicine Care Point Gahanna, The Ohio State University Wexner Medical Center, Gahanna, OH, USA
| | - Katherine K Rethman
- Jameson Crane Sports Medicine Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Matthew S Briggs
- Jameson Crane Sports Medicine Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA.,Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Jameson Crane Sports Medicine Institute, Columbus, OH, USA.,School of Health and Rehabilitation Sciences, College of Medicine, Ohio State University, Columbus, OH, USA.,Department of Orthopaedics, Ohio State University Wexner Medical Center, Columbus, OH, USA
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18
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Merrigan JJ, O'Toole KB, Wutzke CJ, Jones MT. Kinetic and Kinematic Analysis of Various Drop Jump Performances in Army Reserve Officer Training Corps Cadets. J Strength Cond Res 2021; 36:738-746. [PMID: 34132221 DOI: 10.1519/jsc.0000000000004041] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Merrigan, JJ, O'Toole, KB, Wutzke, CJ, and Jones, MT. Kinetic and kinematic analysis of various drop jump performances in army reserve officer training corps cadets. J Strength Cond Res XX(X): 000-000, 2021-The purpose was to examine effects of sex, drop height, and external loads on drop jump mechanics in Reserve Officer Training Corps cadets and whether findings were associated with strength. Males (n = 14) and females (n = 12) completed maximal isokinetic concentric (slow-C and fast-C) and eccentric (slow-E and fast-E) knee extensions and flexions at 60°·s-1 and 180°·s-1. After 72 hours, 3 drop jumps were performed under 3 conditions, (i.e., 30 cm unloaded [30UL], 30 cm loaded 15 kg [30L], and 60 cm unloaded [60UL]). No sex × condition interactions existed for any metric (p > 0.05). The 30L condition resulted in slower eccentric and concentric center of mass (COM) and angular velocities, reduced concentric vertical ground reaction forces (vGRF), and lower jump performances. Although 60UL resulted in greater eccentric COM and angular velocities, peak vGRF, impulse, and rate of force development (p < 0.008), no differences existed in jump performances. Males had faster COM and angular concentric velocities and smaller knee valgus angles, but no different vGRF compared with females. The change in the peak hip angle, because of 60UL, was associated with knee extension eccentric and concentric strength, whereas changes in knee angles were associated with eccentric strength. Likewise, eccentric strength influenced the effects of 30L on landing vGRF more so than concentric strength. Initial strength training is recommended, specifically emphasizing eccentric actions, before performing loaded (15 kg) drop jumps to reduce the increase of landing forces. However, caution may be required when performing drops from 60 cm because of increased forces, although no decline in jump performances were noted.
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Affiliation(s)
- Justin J Merrigan
- Human Performance Innovation Center, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia; Patriot Performance Laboratory, Frank Pettrone Center for Sports Performance, George Mason University, Fairfax, Virginia; School of Nursing and Human Physiology, Gonzaga University, Spokane, Washington; and Sport, Recreation, and Tourism Management, George Mason University, Fairfax, Virginia
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19
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Mozafaripour E, Seidi F, Minoonejad H, Mousavi SH, Bayattork M. Can lower extremity anatomical measures and core stability predict dynamic knee valgus in young men? J Bodyw Mov Ther 2021; 27:358-363. [PMID: 34391258 DOI: 10.1016/j.jbmt.2021.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 01/27/2021] [Accepted: 02/28/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Dynamic knee valgus (DKV) is a risk factor for lower extremity injuries such as anterior cruciate ligament and patellofemoral pain syndrome. Purpose of the current study was to investigate the relationship between lower extremity anatomical measures (LEAM) and core stability with DKV during the single-leg squat. METHODS Thirty healthy men aged between 18 and 28 years participated in this cross-sectional biomechanical study.DKV was assessed using a 6-camera motion analysis system during a single-leg squat task. Anteversion of hip, hip internal and external rotation, Q-angle, knee hyperextension, tibial torsion, tibia vara, plantar arch index, and core stability were measured using standard clinical procedures. To predict DKV, a multiple linear regression model was used. RESULT The stability index negatively and plantar arch index positively predicted greater DKV during the single-leg squat task (P = 0.001 and P = 0.09, respectively). Research variables together predicted 82% of the variance in DKV (F(4,26) = 28.09, p < 0.001). However, relationships between other variables and DKV were not found. CONCLUSION The core stability index and plantar arch index were associated with observed DKV during the single-leg squat. These results suggested that proximal and distal variables to the knee should be considered when evaluating individuals who present DKV during the single-leg squat.
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Affiliation(s)
- Esmaeil Mozafaripour
- Health and Sports Medicine Department, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Foad Seidi
- Health and Sports Medicine Department, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran.
| | - Hooman Minoonejad
- Health and Sports Medicine Department, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Seyed Hamed Mousavi
- Health and Sports Medicine Department, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Mohammad Bayattork
- Sport Sciences and Physical Education, Faculty of Humanities Science, University of Hormozgan, Bandar Abbas, Iran
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20
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A new method for assessing landing kinematics in non-laboratory settings. Phys Ther Sport 2021; 49:21-30. [PMID: 33550202 DOI: 10.1016/j.ptsp.2021.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES 1) Determine the concurrent validity of using automated 2D video analysis relative to 3D motion capture for assessing frontal and sagittal-plane knee kinematics during landing, 2) compare the accuracy of visually estimating joint center locations (2D Manual) with computing joint center locations using anatomical markers (2D Automatic), and 3) compare landing kinematics between a controlled laboratory setting and a non-laboratory setting. DESIGN Validity/repeatability study. SETTINGS Biomechanics research laboratory and non-laboratory athletic facility. PARTICIPANTS Thirty uninjured recreational athletes. MAIN OUTCOME MEASURES Peak knee flexion, knee flexion range of motion, peak knee frontal plane projection angle, and knee frontal plane projection angle range of motion during bilateral and unilateral landing were measured simultaneously in 3D using motion capture and in 2D using two low-cost video cameras during the first study session (biomechanics research laboratory), and in 2D only during the second study session (non-laboratory athletic facility). RESULTS There was good to excellent agreement between 3D motion capture and both 2D Manual (ICC = 0.86-0.99) and 2D Automatic (ICC = 0.89-0.99) video analysis methods. There was good to excellent agreement between data collected in a laboratory and non-laboratory setting (ICC = 0.75-0.95). CONCLUSION The methods introduced in this study are inexpensive, reliable, and feasible for use in non-laboratory settings.
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21
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Collings TJ, Bourne MN, Barrett RS, du Moulin W, Hickey JT, Diamond LE. Risk Factors for Lower Limb Injury in Female Team Field and Court Sports: A Systematic Review, Meta-analysis, and Best Evidence Synthesis. Sports Med 2021; 51:759-776. [DOI: 10.1007/s40279-020-01410-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2020] [Indexed: 02/01/2023]
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22
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Pedley JS, Lloyd RS, Read PJ, Moore IS, De Ste Croix M, Myer GD, Oliver JL. Utility of Kinetic and Kinematic Jumping and Landing Variables as Predictors of Injury Risk: A Systematic Review. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s42978-020-00090-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Abstract
Purpose
Jump-landing assessments provide a means to quantify an individual’s ability to attenuate ground reaction forces, generate lower limb explosive power and maintain joint alignment. In order to identify risk factors that can be targeted through appropriate training interventions, it is necessary to establish which (scalar) objective kinetic, kinematic, and performance measures are most associated with lower-extremity injury.
Methods
Online searches of MEDLINE, SCOPUS, EBSCOHost, SPORTDiscus and PubMed databases were completed for all articles published before March 2020 in accordance with PRISMA guidelines.
Results
40 articles investigating nine jump-landing assessments were included in this review. The 79% of studies using drop jump (n = 14) observed an association with future injury, while only 8% of countermovement jump studies (n = 13) observed an association with injury risk. The 57% of studies using unilateral assessments found associations with risk of injury (n = 14). Studies using performance measures (jump height/distance) as outcome measure were only associated with injury risk in 30% of cases. However, those using kinetic and/or kinematic analyses (knee abduction moment, knee valgus angle, knee separation distance, peak ground reaction force) found associations with injury in 89% of studies.
Conclusion
The landing element of jump-landing assessments appears to be superior for identifying individuals at greater risk of injury; likely due to a closer representation of the injury mechanism. Consequently, jump-landing assessments that involve attenuation of impact forces such as the drop jump appear most suited for this purpose but should involve assessment of frontal plane knee motion and ground reaction forces.
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23
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Kingston B, Murray A, Norte GE, Glaviano NR. Validity and reliability of 2-dimensional trunk, hip, and knee frontal plane kinematics during single-leg squat, drop jump, and single-leg hop in females with patellofemoral pain. Phys Ther Sport 2020; 45:181-187. [PMID: 32823213 DOI: 10.1016/j.ptsp.2020.07.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/15/2020] [Accepted: 07/18/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To investigate validity and between-session reliability of frontal plane trunk, hip, and knee kinematics during three functional tasks in females with patellofemoral pain (PFP). DESIGN Observational. SETTING Research Laboratory. PARTICIPANTS 20 females with PFP (22.7 ± 3.2 years, 69.9 ± 9.2 kg, 167.7 ± 9.6 cm). MAIN OUTCOME MEASURES Trunk, hip, and knee frontal plane peak angles during the single leg squat (SLS), drop vertical jump (DVJ), and single leg hop (SLH) kinematics were evaluated using 2-dimensional (2D) and 3-dimensional (3D) motion capture. Participants returned to the lab one week later and competed a second 2D analysis of the functional tasks. Concurrent validity was assessed by evaluating relationship between 2D and 3D frontal plane kinematics with Pearson correlations. Between-session reliability was assessed by evaluating 2D kinematics with intraclass correlation coefficients by a single assessor. RESULTS Moderate to strong correlations (r = 0.55-0.76, p < .05) were found for frontal plane hip kinematics during all three tasks and the trunk during the SLH. Frontal plane kinematics demonstrated good to excellent test-retest reliability for each of the three tasks, (ICC (2,1) = 0.70-0.90). CONCLUSION 2D hip joint angles during the three functional tasks were the only valid frontal plane angles. Trunk, hip, and knee 2D frontal plane kinematics ranged between good-excellent reliability.
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Affiliation(s)
- Brianna Kingston
- School of Exercise and Rehabilitation Sciences, University of Toledo, Toledo, OH, USA
| | - Amanda Murray
- School of Exercise and Rehabilitation Sciences, University of Toledo, Toledo, OH, USA
| | - Grant E Norte
- School of Exercise and Rehabilitation Sciences, University of Toledo, Toledo, OH, USA
| | - Neal R Glaviano
- School of Exercise and Rehabilitation Sciences, University of Toledo, Toledo, OH, USA.
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Validity of Using Automated Two-Dimensional Video Analysis to Measure Continuous Sagittal Plane Running Kinematics. Ann Biomed Eng 2020; 49:455-468. [PMID: 32705424 DOI: 10.1007/s10439-020-02569-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 07/11/2020] [Indexed: 02/08/2023]
Abstract
Two-dimensional video analysis is commonly used to assess kinematics when three-dimensional motion capture is unavailable. However, videos are often assessed using manual digitization, which limits the ability to extract outcomes that require continuous data. Here, we introduced a method to collect continuous kinematic data in 2D using an inexpensive camera and an open-source automated marker tracking program. We tested the validity of this method by comparing 2D video analysis to 3D motion capture for measuring sagittal-plane running kinematics. Twenty uninjured participants ran on a treadmill for 1-min while lower extremity kinematics were collected simultaneously in 3D using a motion capture system and in 2D using a single digital camera, both at 120 Hz. Knee, ankle, and foot angle at contact, peak knee flexion, knee flexion excursion, and knee-ankle flexion vector coding variability were computed using both the 3D and 2D kinematic data, and were compared using intraclass correlation coefficients and Bland-Altman plots. The agreement between collection methods was excellent for foot angle at contact and knee flexion excursion, good for ankle and knee angle at contact and knee-ankle vector coding variability, and moderate for peak knee flexion. However, Bland-Altman plots revealed significant differences between the 2D and 3D collection methods, which varied across study participants. These low-cost methods could be useful for collecting continuous sagittal plane running kinematics in non-laboratory settings.
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Y-Balance Test Asymmetry and Frontal Plane Knee Projection Angle During Single-leg squat as Predictors of Patellofemoral Pain in Male Military Recruits. Phys Ther Sport 2020; 44:121-127. [DOI: 10.1016/j.ptsp.2020.05.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/15/2020] [Accepted: 05/20/2020] [Indexed: 11/19/2022]
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De Bleecker C, Vermeulen S, De Blaiser C, Willems T, De Ridder R, Roosen P. Relationship Between Jump-Landing Kinematics and Lower Extremity Overuse Injuries in Physically Active Populations: A Systematic Review and Meta-Analysis. Sports Med 2020; 50:1515-1532. [DOI: 10.1007/s40279-020-01296-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wood K, Berg W, Salcedo N, Walsh M, Biller K. The effects of closed and open kinetic chain exercise on strength and onset timing of hip musculature and dynamic knee valgus in women. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2020. [DOI: 10.23736/s0393-3660.19.04072-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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28
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Saito A, Okada K, Sasaki M, Wakasa M. Influence of the trunk position on knee kinematics during the single-leg landing: implications for injury prevention. Sports Biomech 2020; 21:810-823. [DOI: 10.1080/14763141.2019.1691642] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Akira Saito
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
| | - Kyoji Okada
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
| | - Makoto Sasaki
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
| | - Masahiko Wakasa
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
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Silva NC, Silva MDC, Guimarães MG, Nascimento MBDO, Felicio LR. Effects of neuromuscular training and strengthening of trunk and lower limbs muscles in women with Patellofemoral Pain: A protocol of randomized controlled clinical trial, blinded. Trials 2019; 20:586. [PMID: 31604478 PMCID: PMC6788005 DOI: 10.1186/s13063-019-3650-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 08/12/2019] [Indexed: 12/02/2022] Open
Abstract
Background Patellofemoral pain (PFP) often affects young women, and the etiology is multifactorial and poorly understood. Conservative intervention has been focused on risk factors or aggravating factors and is composed of hip- and knee-strengthening exercises, as this population often has muscle weakness and poor motor control during daily and sports activities. The objective of this study was to evaluate the additional effects of neuromuscular training in a conservative treatment of trunk-, hip-, and knee-muscle strengthening on pain, function, and kinematics of the trunk, pelvis, and lower limb in women with PFP. Methods This is a randomised clinical trial, controlled, blinded. Ninety women who are active and engage in physical activity up to twice a week will be recruited. All participants will undergo an individual physiotherapy assessment and then will be allocated randomly into two groups. Thereafter, both groups will undergo a 12-week intervention protocol: group 1 will perform strengthening exercises for the trunk, hip, and knee muscles, while group 2 will receive the same treatment, with the inclusion of neuromuscular training exercises on the fourth week. At the end of the intervention, the volunteers will be evaluated. The primary outcomes will be pain intensity (using a Visual Analog Scale: over the last month, squat 90°, and step of 26 cm during 1 min), functional capacity (Anterior Knee Pain Scale and Activities of Daily Living Scale), and 2D kinematics of the trunk, pelvis, and lower limb during the single-leg squat. The secondary outcomes correspond to the isometric muscular strength of the lower limb and the level of satisfaction from the intervention. Discussion The present study was initiated on 28 January 2018 and is currently in progress, scheduled for completion in July 2019. The results of this study should contribute to the physiotherapeutic treatment of women with PFP by aggregating information on the benefits of adding neuromuscular training to strengthening of the trunk and lower-limb muscles. Trial registration Registro Brasileiro de Ensaios Clínicos, ID: RBR-8c7267. Registered on 2 August 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3650-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Natália Camin Silva
- Programa de Pós-Graduação em Fisioterapia na Universidade Federal de Uberlândia (UFU), Faculdade de Educação Física e Fisioterapia (FAEFI) , Rua Benjamin Constant, 1286, Uberlândia, MG, CEP: 38400-678, Brazil
| | - Matheus de Castro Silva
- Programa de Pós-Graduação em Fisioterapia na Universidade Federal de Uberlândia (UFU), Faculdade de Educação Física e Fisioterapia (FAEFI) , Rua Benjamin Constant, 1286, Uberlândia, MG, CEP: 38400-678, Brazil
| | - Morisa Garcia Guimarães
- Programa de Pós-Graduação em Fisioterapia na Universidade Federal de Uberlândia (UFU), Faculdade de Educação Física e Fisioterapia (FAEFI) , Rua Benjamin Constant, 1286, Uberlândia, MG, CEP: 38400-678, Brazil
| | - Manoela Beatriz de Oliveira Nascimento
- Programa de Pós-Graduação em Fisioterapia na Universidade Federal de Uberlândia (UFU), Faculdade de Educação Física e Fisioterapia (FAEFI) , Rua Benjamin Constant, 1286, Uberlândia, MG, CEP: 38400-678, Brazil
| | - Lilian Ramiro Felicio
- Programa de Pós-Graduação em Fisioterapia na Universidade Federal de Uberlândia (UFU), Faculdade de Educação Física e Fisioterapia (FAEFI) , Rua Benjamin Constant, 1286, Uberlândia, MG, CEP: 38400-678, Brazil.
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Abstract
Patellofemoral pain (PFP) is a common musculoskeletal-related condition that is characterized by insidious onset of poorly defined pain, localized to the anterior retropatellar and/or peripatellar region of the knee. The onset of symptoms can be slow or acutely develop with a worsening of pain accompanying lower-limb loading activities (eg, squatting, prolonged sitting, ascending/descending stairs, jumping, or running). Symptoms can restrict participation in physical activity, sports, and work, as well as recur and persist for years. This clinical practice guideline will allow physical therapists and other rehabilitation specialists to stay up to date with evolving PFP knowledge and practices, and help them to make evidence-based treatment decisions. J Orthop Sports Phys Ther. 2019;49(9):CPG1-CPG95. doi:10.2519/jospt.2019.0302.
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Holden S, Doherty C, Boreham C, Delahunt E. Sex differences in sagittal plane control emerge during adolescent growth: a prospective investigation. Knee Surg Sports Traumatol Arthrosc 2019; 27:419-426. [PMID: 30073383 DOI: 10.1007/s00167-018-5069-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 05/04/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE Females athletes have a higher incidence of non-contact knee joint injuries compared to their male counterparts. This may be attributable to sex-specific differences in neuromuscular control, which arise during the pubertal growth spurt. The purpose of this longitudinal study was to assess the development of landing kinematics of adolescent male and female athletes during the adolescent growth-spurt. METHODS One hundred and eighty-four adolescent athletes (55% male, 45% female; mean age = 13 ± 0.3 years) participated. Testing was undertaken at baseline and then repeated at 6, 12, 18 and 24 months. Participants performed three drop vertical jump (DVJ) trials from a 31 cm box. Frontal and sagittal plane knee joint angles were recorded. The average measurement of the three jumps was used for analysis at each time point. To assess maturation status, participants were categorised according to their age from peak height velocity at baseline. Pre-initial contact knee flexion (pre-IC), peak knee flexion and knee valgus displacement were the dependant variables. The categorical independent variables were sex (male versus female) and time. RESULTS There was a significant sex*time interaction for pre-IC knee flexion, with males increasing knee flexion with time to a greater extent than females. There was no significant sex*time interaction for knee valgus displacement; although females displayed greater knee valgus displacement across all time points. CONCLUSIONS Adolescent male and female athletes display differing kinematic profiles across growth and development. This has clinical relevance for emphasising increased knee flexion, as well as decreasing abnormal frontal plane displacement in injury prevention programmes for adolescent females. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Sinead Holden
- A101 School of Public Health, Physiotherapy and Sports Science, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Dublin, Ireland.
| | - Cailbhe Doherty
- A101 School of Public Health, Physiotherapy and Sports Science, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Dublin, Ireland.,Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Colin Boreham
- A101 School of Public Health, Physiotherapy and Sports Science, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Dublin, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
| | - Eamonn Delahunt
- A101 School of Public Health, Physiotherapy and Sports Science, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Dublin, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
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Nunes GS, Barton CJ, Viadanna Serrão F. Females with patellofemoral pain have impaired impact absorption during a single-legged drop vertical jump. Gait Posture 2019; 68:346-351. [PMID: 30579038 DOI: 10.1016/j.gaitpost.2018.12.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/22/2018] [Accepted: 12/08/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Females with patellofemoral pain (PFP) have been reported to land with altered biomechanics in some, but not all studies. Kinematic alterations previously reported may indicate, and relate to potential impairments in absorbing impact. RESEARCH QUESTION To compare vertical ground reaction force (vGRF) and lower limb kinematics during single-legged drop vertical jumps in females with and without PFP; and establish the relationship between vGRF and kinematics during this task. METHODS Fifty-two physically active females (26 with PFP and 26 controls) participated in the present cross-sectional study. Peak of vGRF was evaluated during landing; and lower limb kinematics in the sagittal and frontal planes during deceleration (landing) and acceleration (take-off) phases were evaluated. RESULTS The PFP group had 11% greater vGRF (p < 0.01); and 13-24% lower hip, knee and ankle excursion in the sagittal plane during acceleration and deceleration phases (p ≤ 0.02) compared to the control group. No significant between group differences (p > 0.05) for hip, knee and ankle excursion in the frontal plane were identified. Greater impact was significantly correlated with reduced knee (r = -0.56), hip (r = -0.50) and ankle (r = -0.41) excursion in the sagittal plane during the acceleration phase in the control group, but not in the PFP group. No significant correlations were found between vGRF and kinematics variables during the deceleration phase in either group. SIGNIFICANCE Impaired ability to absorb load and reduced lower limb movement in the sagittal plane during landing in females with PFP may provide separate treatment targets during rehabilitation.
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Affiliation(s)
- Guilherme S Nunes
- Department of Physiotherapy, São Carlos Federal University, São Carlos, Brazil; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia.
| | - Christian John Barton
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia; Department of Surgery, St Vincent's Hospital, University of Melbourne, Australia
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33
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Rees D, Younis A, MacRae S. Is there a correlation in frontal plane knee kinematics between running and performing a single leg squat in runners with patellofemoral pain syndrome and asymptomatic runners? Clin Biomech (Bristol, Avon) 2019; 61:227-232. [PMID: 30634094 DOI: 10.1016/j.clinbiomech.2018.12.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 11/23/2018] [Accepted: 12/10/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Knee kinematics when running, specifically knee valgus, have been linked to patellofemoral pain syndrome. Assessing running biomechanics requires skill, equipment and time. Clinically, the single leg squat is used to make inferences about knee kinematics during running. No evidence supports this practice. METHODS Sixteen asymptomatic runners and sixteen runners with patellofemoral pain syndrome were recruited. Asymptomatic runners were sub-divided by dominant and non-dominant leg and runners with patellofemoral pain syndrome by painful and non-painful leg. This gave four groups. Participants were videoed performing single leg squats and running on a treadmill. Frontal plane knee kinematics were calculated using the frontal plane projection angle. Correlation in frontal plane projection angle between running and single leg squat were calculated using Pearson's correlation coefficient. Differences in frontal plane projection angle between groups for running and single leg squat were calculated using multiple independent t-tests with Bonferroni correction. FINDINGS Correlation in frontal plane projection angle between running and the single leg squat was not statistically significant for the painful leg group (p = 0.19) but was for the remaining groups (p < 0.05). There was no statistically significant difference in frontal plane projection angle between the four groups when running. Single leg squat frontal plane projection angle was significantly larger for the painful leg group (10.3°) than the dominant leg (-0.2° (p = 0.003)) and non-dominant leg (-0.4° (p = 0.004)) in the asymptomatic runners group. INTERPRETATION The single leg squat cannot be used to make inferences about frontal plane knee kinematics in running gait in patellofemoral pain syndrome sufferers.
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Affiliation(s)
- David Rees
- School of Rehabilitation Sciences, Faculty of Health, Social Care and Education, a partnership between Kingston University and St George's, University of London, SW17 0RE, United Kingdom.
| | - Ahmed Younis
- School of Rehabilitation Sciences, Faculty of Health, Social Care and Education, a partnership between Kingston University and St George's, University of London, SW17 0RE, United Kingdom.
| | - Siân MacRae
- College of Health and Life Sciences, Brunel University London, Mary Seacole Building, Kingston Lane, Uxbridge UB8 3PH, United Kingdom; Therapy Department, Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Rd, London SW10 9NH, United Kingdom.
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Simon M, Parizek C, Earl-Boehm JE, Bazett-Jones DM. Quantitative and qualitative assessment of frontal plane knee motion in males and females: A reliability and validity study. Knee 2018; 25:1057-1064. [PMID: 30414788 DOI: 10.1016/j.knee.2018.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 08/29/2018] [Accepted: 09/08/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The aim was to determine reliability and validity of frontal plane projection angle (FPPA) and visual assessments (VA) in both males and females. METHODS Fifty-four participants (30 females) performed lateral step-downs while kinematics were recorded by two-dimensional and three-dimensional analyses. Two raters viewed the videos, extracted images, and measured the FPPA (quantitative). Using the videos, the raters also categorized (qualitative VA) each participant's motion as demonstrating dynamic valgus (>10° valgus), dynamic varus (>10° varus), or no change. Reliability was assessed for FPPA and VA using intraclass correlation coefficients and Kappa, respectively. Validity was determined by comparing the FPPA to three-dimensional measures (Pearson correlations) and comparing the VA to both FPPA and standard reference 3D kinematics (Kappa). RESULTS FPPA showed good-excellent reliability (ICC = 0.850-0.998). VA showed minimal-moderate reliability (κ = 0.370-0.766). The FPPA showed large correlations (r = -0.514-0.531) with hip adduction in both sexes but only a moderate relationship with knee abduction in males (r = 0.427-0.445). VA showed no-weak (κ = 0.153-0.475) and weak-moderate (κ = 0.455-0.698) agreement compared to FPPA and no-weak (κ = -0.300-0.183) and no-minimal (κ = -0.078-0.027) disagreement compared to the reference standard 3D kinematics in males and females, respectively. CONCLUSION The quantitative FPPA is more reliable and valid than qualitative VA of frontal knee plane motion.
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Affiliation(s)
| | - Chloe Parizek
- Carroll University, 100 N East Ave, Waukesha, WI, USA
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35
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Nakagawa TH, Petersen RS. Relationship of hip and ankle range of motion, trunk muscle endurance with knee valgus and dynamic balance in males. Phys Ther Sport 2018; 34:174-179. [DOI: 10.1016/j.ptsp.2018.10.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 10/14/2018] [Accepted: 10/14/2018] [Indexed: 12/14/2022]
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36
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Neal BS, Lack SD, Lankhorst NE, Raye A, Morrissey D, van Middelkoop M. Risk factors for patellofemoral pain: a systematic review and meta-analysis. Br J Sports Med 2018; 53:270-281. [PMID: 30242107 DOI: 10.1136/bjsports-2017-098890] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Patellofemoral pain (PFP) is a prevalent condition commencing at various points throughout life. We aimed to provide an evidence synthesis concerning predictive variables for PFP, to aid development of preventative interventions. METHODS We searched Medline, Web of Science and SCOPUS until February 2017 for prospective studies investigating at least one potential risk factor for future PFP. Two independent reviewers appraised methodological quality using the Newcastle-Ottawa Scale. We conducted meta-analysis where appropriate, with standardised mean differences (SMD) and risk ratios calculated for continuous and nominal scaled data. RESULTS This review included 18 studies involving 4818 participants, of whom 483 developed PFP (heterogeneous incidence 10%). Three distinct subgroups (military recruits, adolescents and recreational runners) were identified. Strong to moderate evidence indicated that age, height, weight, body mass index (BMI), body fat and Q angle were not risk factors for future PFP. Moderate evidence indicated that quadriceps weakness was a risk factor for future PFP in the military, especially when normalised by BMI (SMD -0.69, CI -1.02, -0.35). Moderate evidence indicated that hip weakness was not a risk factor for future PFP (multiple pooled SMDs, range -0.09 to -0.20), but in adolescents, moderate evidence indicated that increased hip abduction strength was a risk factor for future PFP (SMD 0.71, CI 0.39, 1.04). CONCLUSIONS This review identified multiple variables that did not predict future PFP, but quadriceps weakness in military recruits and higher hip strength in adolescents were risk factors for PFP. Identifying modifiable risk factors is an urgent priority to improve prevention and treatment outcomes.
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Affiliation(s)
- Bradley S Neal
- Sports and Exercise Medicine, Queen Mary University of London, London, UK.,Pure Sports Medicine, London, UK
| | - Simon D Lack
- Sports and Exercise Medicine, Queen Mary University of London, London, UK.,Pure Sports Medicine, London, UK
| | | | - Andrew Raye
- Sports and Exercise Medicine, Queen Mary University of London, London, UK
| | - Dylan Morrissey
- Sports and Exercise Medicine, Queen Mary University of London, London, UK.,Physiotherapy Department, Barts Health NHS Trust, London, UK
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37
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The assessment of movement health in clinical practice: A multidimensional perspective. Phys Ther Sport 2018; 32:282-292. [DOI: 10.1016/j.ptsp.2018.04.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 11/07/2017] [Accepted: 04/10/2018] [Indexed: 12/11/2022]
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Toivo K, Kannus P, Kokko S, Alanko L, Heinonen OJ, Korpelainen R, Savonen K, Selänne H, Vasankari T, Kannas L, Kujala UM, Villberg J, Parkkari J. Musculoskeletal examination in young athletes and non-athletes: the Finnish Health Promoting Sports Club (FHPSC) study. BMJ Open Sport Exerc Med 2018; 4:e000376. [PMID: 29955377 PMCID: PMC6018865 DOI: 10.1136/bmjsem-2018-000376] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 04/04/2018] [Accepted: 04/04/2018] [Indexed: 12/26/2022] Open
Abstract
Objectives To determine the inter-rater repeatability of a musculoskeletal examination and to compare findings between adolescent athletes and non-athletes in Finland. Methods In this cross-sectional study, a musculoskeletal examination assessing posture, mobility and movement control was carried out by a sports and exercise medicine physician on 399 athletes aged 14–17 years and 177 non-athletes. Within 2 weeks another sports and exercise medicine physician repeated the examination for 41 adolescents to test the inter-rater repeatability. Results In total, 10 of the 11 tests performed had at least moderate inter-rater reliability (κ ≥0.4 or percentage agreement >80%). Athletes more often than non-athletes had one shoulder protruded (8.0% vs 4.0%, OR 2.81, 95% CI 1.16 to 6.81). Forty-six per cent of athletes had good knee control in the two-legged vertical drop jump test compared with 32% of non-athletes (OR 1.99, 95% CI 1.29 to 3.06). Athletes had better core muscle control with 86.3% being able to remain in the correct plank position for 30 s compared with 68.6% of non-athletes (OR 2.70, 95% CI 1.67 to 4.36). In the deep squat test, good lumbar spine control was maintained only by 35.8% of athletes and 38.4% of non-athletes. Conclusion A basic musculoskeletal examination is sufficiently reliable to be performed by trained physicians as a part of a periodic health evaluation. Shortfalls in mobility, posture and movement control are common in both athletes and non-athletes. These deficits could have been caused by sedentary behaviour, monotonous training, or both.
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Affiliation(s)
- Kerttu Toivo
- Tampere Research Center of Sports Medicine, Tampere, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - Pekka Kannus
- Tampere Research Center of Sports Medicine, Tampere, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Lauri Alanko
- Clinic for Sports and Exercise Medicine, Helsinki, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre & Unit of Health and Physical Activity, University of Turku, Turku, Finland
| | - Raija Korpelainen
- Department of Sports and Exercise Clinic, Oulu Deaconess Institute, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center, University of Oulu and University Hospital of Oulu, Oulu, Finland
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Harri Selänne
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Lasse Kannas
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, Tampere, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
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Neto JBDS, Fukuda TY. Letter to editor in chief: Do hip muscle weakness and dynamic knee valgus matter for the clinical evaluation and decision making process in patients with patellofemoral pain? Braz J Phys Ther 2018; 22:431-432. [PMID: 29804649 DOI: 10.1016/j.bjpt.2018.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 03/27/2018] [Accepted: 05/03/2018] [Indexed: 11/26/2022] Open
Affiliation(s)
- João Barboza da Silva Neto
- Instituto Trata - Joelho e Quadril, São Paulo, SP, Brazil; Faculdade de Medicina do ABC, Santo André, SP, Brazil.
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40
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Rabelo NDDA, Lucareli PRG. Response the letter to the editor for the masterclass: Do hip muscle weakness and dynamic knee valgus matter for the clinical evaluation and decision-making process in patients with patellofemoral pain? Braz J Phys Ther 2018; 22:432-433. [PMID: 29804648 DOI: 10.1016/j.bjpt.2018.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 05/03/2018] [Indexed: 10/16/2022] Open
Affiliation(s)
- Nayra Deise Dos Anjos Rabelo
- Human Motion Analysis Laboratory, Rehabilitation Science Department, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Paulo Roberto Garcia Lucareli
- Human Motion Analysis Laboratory, Rehabilitation Science Department, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil.
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Xu X, Yao C, Wu R, Yan W, Yao Y, Song K, Jiang Q, Shi D. Prevalence of patellofemoral pain and knee pain in the general population of Chinese young adults: a community-based questionnaire survey. BMC Musculoskelet Disord 2018; 19:165. [PMID: 29793456 PMCID: PMC5968546 DOI: 10.1186/s12891-018-2083-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 05/08/2018] [Indexed: 01/17/2023] Open
Abstract
Background Previous studies that have described the prevalence of patellofemoral pain (PFP) have been limited to samples of military personnel or sporting populations, and convincing data in the general Chinese population are lacking. The present study defined the prevalence of PFP and knee pain in the general population of Chinese young adults and evaluated whether gender, age, or body mass index (BMI) were associated with PFP. Methods An anonymous online questionnaire survey was open to the general public in China. A self-report questionnaire was used to specifically identify PFP. The population aged 18–40 years was enrolled in the study and completed the questionnaire. The prevalence of PFP and knee pain in the overall sample and in subgroups stratified by sex, age, and BMI was estimated. Logistic regression analysis was conducted to determine if there was a significant association between PFP and sex, age, or BMI. Results A total of 1153 participants were enrolled in the study. The prevalence of PFP in the overall sample and among the male and female participants was 20.7, 20.3, and 21.2%, respectively. The prevalence of the knee pain in the overall sample and among the male and female participants was 35.6, 38.2, and 33.7%, respectively. The prevalence of PFP in the subgroups stratified by age and BMI did not differ significantly between the groups. Gender, age, and BMI did not have significant associations with the prevalence of PFP. Conclusion PFP is common in the general Chinese population. Clinicians should direct more attention toward the early diagnosis of and interventions for PFP.
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Affiliation(s)
- Xingquan Xu
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital, School of Medicine, Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu, 210008, People's Republic of China.,Joint Research Center for Bone and Joint Disease, Model Animal Research Center (MARC), Nanjing University, Nanjing, Jiangsu, 210093, People's Republic of China
| | - Chen Yao
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital, School of Medicine, Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu, 210008, People's Republic of China.,Joint Research Center for Bone and Joint Disease, Model Animal Research Center (MARC), Nanjing University, Nanjing, Jiangsu, 210093, People's Republic of China
| | - Rui Wu
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital, School of Medicine, Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu, 210008, People's Republic of China
| | - Wenjin Yan
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital, School of Medicine, Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu, 210008, People's Republic of China
| | - Yao Yao
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital, School of Medicine, Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu, 210008, People's Republic of China
| | - Kai Song
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital, School of Medicine, Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu, 210008, People's Republic of China.,Joint Research Center for Bone and Joint Disease, Model Animal Research Center (MARC), Nanjing University, Nanjing, Jiangsu, 210093, People's Republic of China
| | - Qing Jiang
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital, School of Medicine, Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu, 210008, People's Republic of China. .,Joint Research Center for Bone and Joint Disease, Model Animal Research Center (MARC), Nanjing University, Nanjing, Jiangsu, 210093, People's Republic of China.
| | - Dongquan Shi
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital, School of Medicine, Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu, 210008, People's Republic of China. .,Joint Research Center for Bone and Joint Disease, Model Animal Research Center (MARC), Nanjing University, Nanjing, Jiangsu, 210093, People's Republic of China.
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Räisänen AM, Arkkila H, Vasankari T, Steffen K, Parkkari J, Kannus P, Forsman H, Pasanen K. Investigation of knee control as a lower extremity injury risk factor: A prospective study in youth football. Scand J Med Sci Sports 2018; 28:2084-2092. [DOI: 10.1111/sms.13197] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2018] [Indexed: 01/16/2023]
Affiliation(s)
- A. M. Räisänen
- Tampere Research Center of Sports Medicine; UKK Institute for Health Promotion Research; Tampere Finland
| | - H. Arkkila
- Faculty of Medicine and Life Sciences; University of Tampere; Tampere Finland
| | - T. Vasankari
- UKK Institute for Health Promotion Research; Tampere Finland
| | - K. Steffen
- Oslo Sports Trauma Research Center; Norwegian School of Sports Sciences; Oslo Norway
| | - J. Parkkari
- Tampere Research Center of Sports Medicine; UKK Institute for Health Promotion Research; Tampere Finland
| | - P. Kannus
- UKK Institute for Health Promotion Research; Tampere Finland
| | - H. Forsman
- Eerikkilä Sports Institute Training Center; Tammela Finland
| | - K. Pasanen
- Tampere Research Center of Sports Medicine; UKK Institute for Health Promotion Research; Tampere Finland
- Faculty of Kinesiology; Sport Injury Prevention Research Centre; University of Calgary; Calgary AB Canada
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Kerkhoff A, Wagner H, Nagel A, Möller M, Peikenkamp K. Effects of two different foot orthoses on muscle activity in female during single-leg landing. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2017. [DOI: 10.1007/s12662-017-0474-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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