Patellofemoral Pain Syndrome Risk Associated with Squats: A Systematic Review

Patellofemoral pain syndrome in children and adolescents: A cross-sectional study

OBJECTIVES

To assess the prevalence and associated factors of Patellofemoral Pain Syndrome (PFPS) in children and adolescents.

METHOD

A population-based cross-sectional study was conducted with children and adolescents aged 10 to 18 years, who presented a history of peripatellar and/or retropatellar pain, attending elementary or high school in urban public schools in Natal, Brazil. The sample size was calculated based on a minimum outcome prevalence of 22%.

RESULTS

A prevalence of 24.7% of PFPS was found. There was a positive association of PFPS with active students (p < 0.01; PR: 2.5; CI: 1.4-4.5), low functional capacity (p < 0.01; PR: 8.0; CI: 5.0-12.8), and those classified as pubertal (p < 0.03; PR: 1.8; CI: 1.0-3.2).

CONCLUSION

There was a considerable prevalence of PFPS in children and adolescents, as well as an association between the level of sexual maturation and adjustable determinants, such as the level of physical activity and low functional capacity in this group.

The effect of experimentally induced gluteal muscle weakness on joint kinematics, reaction forces, and dynamic balance performance during deep bilateral squats

Squatting is a common daily activity and fundamental exercise in resistance training and closed kinetic chain programs. The aim of this study was to investigate the effects of an experimentally induced weakness of the gluteal muscles on joint kinematics, reactions forces (JRFs), and dynamic balance performance during deep bilateral squats in healthy young adults. Ten healthy adults received sequential blocks of (1) branch of the superior gluteal nerve to the tensor fasciae latae (SGNtfl) muscle, (2) superior gluteal nerve (SGN), and (3) inferior gluteal nerve (IGN) on the dominant right leg. At the control condition and following each block, the participants were instructed to perform deep bilateral squats standing on two force plates. Hip, knee, ankle, and pelvis kinematics did not differ significantly following iatrogenic weakness of gluteal muscles. The most important finding was the significant differences in JRFs following SGN and IGN block, with the affected hip, patellofemoral, and ankle joint demonstrating lower JRFs, whereas the contralateral joints demonstrated significantly higher JRFs, especially the patellofemoral joint which demonstrated an average maximum difference of 1.43 x body weight compared with the control condition. When performing a deep bilateral leg squat under SGN and IGN block, the subjects demonstrated an increased center of pressure (CoP) range and standard deviation (SD) in mediolateral compared with the control condition. These results imply that squat performance changes significantly following weakness of gluteal muscles and should be considered when assessing and training athletes or patients with these injuries.

Effects of step lengths on biomechanical characteristics of lower extremity during split squat movement

Objective: To quantify the effects of increasing the step length of the split squat on changes in kinematics, kinetics, and muscle activation of the lower extremity. Methods: Twenty male college students participated in the test (age: 23.9 ± 3.7, height: 175.1 ± 4.9). Data on kinematics, kinetics, and EMG were collected during split squat exercise at four different step lengths in a non-systematic manner. One-way repeated measurements ANOVA were used to compare characteristic variables of peak angle, moment, and RMS among the four step length conditions. Results: The step length significantly changes the peak angles of the hip (p = 0.011), knee (p = 0.001), ankle (p < 0.001) joint, and the peak extension moment of the hip (p < 0.001), knee (p = 0.002) joint, but does not affect the ankle peak extension moment (p = 0.357) during a split squat. Moreover, a significant difference was observed in the EMG of gluteus maximus (p < 0.001), vastus medialis (p = 0.013), vastus lateralis (p = 0.020), biceps femoris (p = 0.003), Semitendinosus (p < 0.001), medialis gastrocnemius (p = 0.035) and lateralis gastrocnemius (p = 0.005) during four step lengths, but no difference in rectus femoris (p = 0.16). Conclusion: Increases in step length of split squat had a greater activation on the hip extensor muscles while having a limited impact on the knee extensor muscles. The ROM, joint moment, and muscle activation of the lead limb in the split squat all should be considered in cases of individual preventative or rehabilitative prescription of the exercise. Moreover, the optimal step length for strength training in healthy adults appears to be more suitable when it is equal to the length of the individual lower extremity.

Comparing the effect of intermittent blood flow restriction training and high-load resistance training in patients with patellofemoral pain: study protocol for a randomised trial

BACKGROUND

Patellofemoral pain (PFP) syndrome is a common knee joint functional disorder. Blood flow restriction (BFR) training has shown promise in improving PFP; however, the effectiveness of intermittent BFR (iBFR) training remains uncertain. This study aims to compare the rehabilitative effects of iBFR combined with low-load resistance training and high-load resistance training in PFP patients and to assess the effectiveness of iBFR combined with low-load resistance training for improving PFP.

METHODS AND ANALYSIS

This randomised, patient-assessor blinded, controlled trial will include 42 eligible PFP patients randomly allocated to an intervention group (iBFR combined with low-load resistance training) or a control group (high-load resistance training) in a 1:1 ratio. Participants will receive interventions three times per week for 8 weeks and will be followed up for 24 weeks. The primary outcome measure is pain, and the secondary outcomes include self-reported function, quality of life, muscle strength and muscle thickness. Assessments will be conducted at baseline, 8 weeks and 24 weeks during follow-up. Intention-to-treat analysis will be performed.Collectively, we expect that the findings of this randomised clinical trial will contribute to understanding the potential benefits of iBFR training and provide insightful guidance for developing more effective treatment strategies for patients with PFP.

ETHICS AND DISSEMINATION

This study was approved by the Sports Science Experiment Ethics Committee of Beijing Sport University (2022274H). Written informed consent will be obtained from all participants. Trial results will be disseminated through peer-reviewed publications.

TRIAL REGISTRATION NUMBER

Chinese Clinical Trial Registry (ChiCTR2300068281).

Smart Chemical Sensor and Biosensor Networks for Healthcare 4.0

Driven by technological advances from Industry 4.0, Healthcare 4.0 synthesizes medical sensors, artificial intelligence (AI), big data, the Internet of things (IoT), machine learning, and augmented reality (AR) to transform the healthcare sector. Healthcare 4.0 creates a smart health network by connecting patients, medical devices, hospitals, clinics, medical suppliers, and other healthcare-related components. Body chemical sensor and biosensor networks (BSNs) provide the necessary platform for Healthcare 4.0 to collect various medical data from patients. BSN is the foundation of Healthcare 4.0 in raw data detection and information collecting. This paper proposes a BSN architecture with chemical sensors and biosensors to detect and communicate physiological measurements of human bodies. These measurement data help healthcare professionals to monitor patient vital signs and other medical conditions. The collected data facilitates disease diagnosis and injury detection at an early stage. Our work further formulates the problem of sensor deployment in BSNs as a mathematical model. This model includes parameter and constraint sets to describe patient body characteristics, BSN sensor features, as well as biomedical readout requirements. The proposed model's performance is evaluated by multiple sets of simulations on different parts of the human body. Simulations are designed to represent typical BSN applications in Healthcare 4.0. Simulation results demonstrate the impact of various biofactors and measurement time on sensor selections and readout performance.