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Gu Y, Zheng Z, Zeng Q, Yang C, Song Y, Wan X. Acute effects of negative heel shoes on perceived pain and knee biomechanical characteristics of runners with patellofemoral pain. J Foot Ankle Res 2024; 17:e12001. [PMID: 38551203 PMCID: PMC11296720 DOI: 10.1002/jfa2.12001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/06/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND To determine the effects of negative heel shoes on perceived pain and knee biomechanical characteristics of runners with patellofemoral pain (PFP) during running. METHODS Sixteen runners with PFP ran in negative (-11 mm drops) and positive (5 mm drops) heel shoes while visual analog scale (VAS) scores, retroreflective markers, and ground reaction force were acquired by applying a 10-cm VAS, infrared motion capture system, and a three-dimensional force plate. Knee moment, patellofemoral joint stress (PFJS), and other biomechanical parameters during the stance phase were calculated based on inverse dynamics and a biomechanical model of the patellofemoral joint. RESULTS The foot inclination angle, peak PFJS during the stance phase, patellofemoral joint reaction force, knee extension moment, and quadriceps force at the time of peak PFJS of runners with PFP in negative heel shoes were lower than that in positive heel shoes, no significant difference was found in VAS scores, knee flexion angle, patellofemoral contact area, and quadriceps moment arm at the time of peak PFJS. CONCLUSIONS Compared to positive heel shoes, running in negative heel shoes decreases peak PFJS in runners with PFP, which may decrease patellofemoral joint loading, thus reducing the possibility of further development of PFP. TRAIL REGISTRATION Sports Science Experiment Ethics Committee of Beijing Sport University. 2023095H, April 18, 2023 (prospectively registered).
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Affiliation(s)
- Yu Gu
- Department of Sports BiomechanicsBeijing Sport UniversityBeijingChina
| | - Zhiyi Zheng
- ANTA Sports Science LaboratoryANTA (China) Co., Ltd.XiamenChina
| | - Quanshou Zeng
- ANTA Sports Science LaboratoryANTA (China) Co., Ltd.XiamenChina
| | - Chen Yang
- School of Sports and HealthNanjing Sport InstituteNanjingChina
| | - Yu Song
- Department of Health, Sport, & Exercise SciencesUniversity of KansasLawrenceKansasUSA
| | - Xianglin Wan
- Department of Sports BiomechanicsBeijing Sport UniversityBeijingChina
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Nair T, Kumar GP. Correlation Between Severity of Symptoms and Quality of Life in Patellofemoral Pain Syndromes: A Cross-Sectional Study. Cureus 2023; 15:e49094. [PMID: 38125224 PMCID: PMC10731623 DOI: 10.7759/cureus.49094] [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] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
Background Patellofemoral pain syndrome (PFPS) is one of the conditions frequently encountered by musculoskeletal physiotherapists. The intensity and severity of pain and symptoms seen in PFPS affect the quality of life (QOL). This concept has not yet been investigated with the use of reliable and valid scales. Hence, the objective of this study is to find out the correlation between the severity of symptoms and QOL in patients with PFPS. Methodology In this cross-sectional study, 63 patients with PFPS, aged between 40 and 60 years, who visited Sir Sayajirao General Hospital, Vadodara, from December 2018 to June 2019, were included. The questionnaires included in the study comprised the Numerical Pain Rating Scale (NPRS), the Knee Osteoarthritis Outcome Survey-Patellofemoral Subscale (KOOS-PF), and the Short Form-36 (SF-36). Spearman's rank correlation coefficient was used to find the correlation. Results NPRS was found to have a fairly positive correlation with the functional scale KOOS-PF, with a P-value of 0.008. Among the eight components of SF-36, Physical Function and General Health scores exhibited a fairly positive correlation with NPRS, with p-values of 0.016 and <0.001, respectively. However, no correlation was observed between NPRS and the other components of SF-36. Conclusions This study concluded that patients with PFPS with different levels of pain exhibit different functional and QOL limitations. Furthermore, studies investigating the causes of the negative correlation should be conducted to have a better understanding of QOL in PFPS.
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Affiliation(s)
- Tushara Nair
- College of Physiotherapy, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, IND
| | - G Palani Kumar
- College of Physiotherapy, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, IND
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Bazett-Jones DM, Neal BS, Legg C, Hart HF, Collins NJ, Barton CJ. Kinematic and Kinetic Gait Characteristics in People with Patellofemoral Pain: A Systematic Review and Meta-analysis. Sports Med 2023; 53:519-547. [PMID: 36334239 DOI: 10.1007/s40279-022-01781-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Patellofemoral pain (PFP) is a prevalent knee condition with many proposed biomechanically orientated etiological factors and treatments. OBJECTIVE We aimed to systematically review and synthesize the evidence for biomechanical variables (spatiotemporal, kinematic, kinetic) during walking and running in people with PFP compared with pain-free controls, and determine if biomechanical variables contribute to the development of PFP. DESIGN Systematic review and meta-analysis. DATA SOURCES We searched Medline, CINAHL, SPORTDiscus, Embase, and Web of Science from inception to October 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES All study designs (prospective, case-control [± interventional component, provided pre-intervention data were reported for both groups], cross-sectional) comparing spatiotemporal, kinematic, and/or kinetic variables during walking and/or running between people with and without PFP. RESULTS We identified 55 studies involving 1300 people with PFP and 1393 pain-free controls. Overall pooled analysis identified that people with PFP had slower gait velocity [moderate evidence, standardized mean difference (SMD) - 0.50, 95% confidence interval (CI) - 0.72, - 0.27], lower cadence (limited evidence, SMD - 0.43, 95% CI - 0.74, - 0.12), and shorter stride length (limited evidence, SMD - 0.46, 95% CI - 0.80, - 0.12). People with PFP also had greater peak contralateral pelvic drop (moderate evidence, SMD - 0.46, 95% CI - 0.90, - 0.03), smaller peak knee flexion angles (moderate evidence, SMD - 0.30, 95% CI - 0.52, - 0.08), and smaller peak knee extension moments (limited evidence, SMD - 0.41, 95% CI - 0.75, - 0.07) compared with controls. Females with PFP had greater peak hip flexion (moderate evidence, SMD 0.83, 95% CI 0.30, 1.36) and rearfoot eversion (limited evidence, SMD 0.59, 95% CI 0.03, 1.14) angles compared to pain-free females. No significant between-group differences were identified for all other biomechanical variables. Data pooling was not possible for prospective studies. CONCLUSION A limited number of biomechanical differences exist when comparing people with and without PFP, mostly characterized by small-to-moderate effect sizes. People with PFP ambulate slower, with lower cadence and a shortened stride length, greater contralateral pelvic drop, and lower knee flexion angles and knee extension moments. It is unclear whether these features are present prior to PFP onset or occur as pain-compensatory movement strategies given the lack of prospective data. TRIAL REGISTRATION PROSPERO # CRD42019080241.
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Affiliation(s)
- David M Bazett-Jones
- Department of Exercise and Rehabilitation Sciences, The University of Toledo, Toledo, OH, USA.
| | - Bradley S Neal
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, Essex, UK.,Sports and Exercise Medicine, School of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University of London, Mile End Hospital, Bancroft Road, London, E1 4DG, UK
| | - Christopher Legg
- Physiotherapy Department, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Harvi F Hart
- School of Physical Therapy and Bone and Joint Institute, Western University, London, ON, Canada
| | - Natalie J Collins
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, QLD, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services, and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Christian J Barton
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services, and Sport, La Trobe University, Bundoora, VIC, Australia.,Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia
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Liu Y, Qi Y, Song Y, Feng L, Wang L. Influences of altering footstrike pattern and cadence on lower extremity joint coordination and variability among runners with patellofemoral pain. PLoS One 2023; 18:e0280477. [PMID: 36689415 PMCID: PMC9870107 DOI: 10.1371/journal.pone.0280477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/03/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Patellofemoral pain (PFP) is a common overuse injury among runners. It is not only a hindrance to the runner's training, but also to the runner's quality of life. PFP runners may strategize different running strategies to reduce patellofemoral joint stress, release pain, and improve function. PURPOSE This study aimed to determine the changes in joint coordination and variability under combinations of foot strike pattern and cadence for runners with patellofemoral pain. METHODS Twenty male runners with PFP performed six running strategies which were two strike patterns named forefoot (FFS) and rearfoot (RFS) accompanied by three running cadences named slow10%, normal, and fast10%. A modified vector coding technique and circular statistics were respectively used to identify the coordination pattern and variability between hip sagittal-knee frontal (HsKf), hip sagittal-knee sagittal (HsKs) and knee transverse-ankle frontal (KtAf) during stance phase. Coordination patterns which were conformed with anatomical motion pattern was classified as mechanically sound, and the distribution frequency of each coordination pattern was quantified. RESULTS Switching to FFS, the HsKf couples (p < 0.001, ES = 1.34) and the HsKs couples (p = 0.001, ES = 0.82) displayed significantly greater frequency in mechanically unsound coordination pattern during the initial stance phase. The effect of increasing running cadence on RFS displayed significantly greater frequency in mechanically unsound hip dominancy (p = 0.042, ES = 0.65) and knee dominancy (p = 0.05, ES = 0.70) coordination patterns for HsKf couples as well as for HsKs couples (p = 0.023, ES = 0.86) during the initial stance phase. Combined with FFS and fast10% cadence, HsKs couples showed more hip-dominated mechanical sound coordination pattern (p = 0.002, ES = 1.25). Further, altering footstrike pattern and cadence failed to change the coordination variability. CONCLUSIONS Changing running cadence (± 10%) combined with transfer strike pattern from RFS to FFS could not increase the distribution frequency in mechanically sound coordination patterns and change coordination variability for PFP runners.
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Affiliation(s)
- Yue Liu
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, China
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Yujie Qi
- Nan Xiang Community Healthcare Center, Shanghai, China
| | - Yanliqing Song
- College of Sports, Nanjing Tech University, Nanjing, China
| | - Li Feng
- Affiliated Sport Polytechnic, Shanghai University of Sport, Shanghai, China
| | - Lin Wang
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, China
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai, China
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Muniz AMDS, Zeitoune G, Alvim F, Grassi GBA, Britto PAA, Nadal J. Do exist differences in kinematics and EMG of the hip and knee between male runners with and without patellofemoral pain in different running speeds? Phys Ther Sport 2023; 59:122-129. [PMID: 36529056 DOI: 10.1016/j.ptsp.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Patellofemoral pain (PFP) presents a higher prevalence in female runners, while PFP in male is somehow neglected. Moreover, the effects of progressive greater running speed have not been reported. This study investigates the influence of progressive greater running speed on lower limb tridimensional kinematics and muscle activation (EMG) in male runners with PFP while compared with controls. DESIGN Cross-Sectional Design. METHODS Thirteen runners with PFP and 18 controls ran in a treadmill under three different speeds: 9, 11, and 13 km/h. Principal component scores from kinematic data and EMG onset and amplitude were used to compare groups through the Mann-Whitney test at each running speed. RESULTS Male PFP subjects presented increased hip internal rotation at 11 km/h and increased hip and knee internal at 13 km/h, as well as reduced knee adduction at all speeds. PFP subjects also ran with delayed and shorter vastus medialis oblique pre-activation compared with normal subjects. CONCLUSIONS This study demonstrated that PFP increased knee and hip internal rotation at higher demand running, therefore, it is important to evaluate the transverse plane of the hip and knee biomechanics in male runners with PFP to optimize the rehabilitation and reconditioning method of these subjects.
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Affiliation(s)
- Adriane Mara de Souza Muniz
- Escola de Educação Física do Exército, EsEFEx, Exército Brasileiro, Rio de Janeiro, RJ, Brazil; Programa de Engenharia Biomédica - PEB/COPPE, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brazil.
| | - Gabriel Zeitoune
- Programa de Engenharia Biomédica - PEB/COPPE, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brazil
| | - Felipe Alvim
- Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, SUPREMA, Juiz de Fora, MG, Brazil
| | - Giordano B A Grassi
- Escola de Educação Física do Exército, EsEFEx, Exército Brasileiro, Rio de Janeiro, RJ, Brazil
| | - Paulo A A Britto
- Programa de Engenharia Biomédica - PEB/COPPE, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brazil
| | - Jurandir Nadal
- Programa de Engenharia Biomédica - PEB/COPPE, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brazil
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Shokouhyan SM, Davoudi M, Hoviattalab M, Abedi M, Bervis S, Parnianpour M, Brumagne S, Khalaf K. Distinction of non-specific low back pain patients with proprioceptive disorders from healthy individuals by linear discriminant analysis. Front Bioeng Biotechnol 2022; 10:1078805. [PMID: 36582840 PMCID: PMC9792676 DOI: 10.3389/fbioe.2022.1078805] [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: 10/24/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
The central nervous system (CNS) dynamically employs a sophisticated weighting strategy of sensory input, including vision, vestibular and proprioception signals, towards attaining optimal postural control during different conditions. Non-specific low back pain (NSLBP) patients frequently demonstrate postural control deficiencies which are generally attributed to challenges in proprioceptive reweighting, where they often rely on an ankle strategy regardless of postural conditions. Such impairment could lead to potential loss of balance, increased risk of falling, and Low back pain recurrence. In this study, linear and non-linear indicators were extracted from center-of-pressure (COP) and trunk sagittal angle data based on 4 conditions of vibration positioning (vibration on the back, ankle, none or both), 2 surface conditions (foam or rigid), and 2 different groups (healthy and non-specific low back pain patients). Linear discriminant analysis (LDA) was performed on linear and non-linear indicators to identify the best sensory condition towards accurate distinction of non-specific low back pain patients from healthy controls. Two indicators: Phase Plane Portrait ML and Entropy ML with foam surface condition and both ankle and back vibration on, were able to completely differentiate the non-specific low back pain groups. The proposed methodology can help clinicians quantitatively assess the sensory status of non-specific low back pain patients at the initial phase of diagnosis and throughout treatment. Although the results demonstrated the potential effectiveness of our approach in Low back pain patient distinction, a larger and more diverse population is required for comprehensive validation.
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Affiliation(s)
| | - Mehrdad Davoudi
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran,Clinic for Orthopaedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Maryam Hoviattalab
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Mohsen Abedi
- Department of Physiotherapy, Faculty of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soha Bervis
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran,Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohamad Parnianpour
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Simon Brumagne
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Kinda Khalaf
- Department of Biomedical Engineering, Healthcare Engineering Innovation Center, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates,*Correspondence: Kinda Khalaf,
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Waiteman MC, Chia L, Ducatti MHM, Bazett-Jones DM, Pappas E, de Azevedo FM, Briani RV. Trunk Biomechanics in Individuals with Knee Disorders: A Systematic Review with Evidence Gap Map and Meta-analysis. SPORTS MEDICINE - OPEN 2022; 8:145. [PMID: 36503991 PMCID: PMC9742076 DOI: 10.1186/s40798-022-00536-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/15/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The trunk is the foundation for transfer and dissipation of forces throughout the lower extremity kinetic chain. Individuals with knee disorders may employ trunk biomechanical adaptations to accommodate forces at the knee or compensate for muscle weakness. This systematic review aimed to synthesize the literature comparing trunk biomechanics between individuals with knee disorders and injury-free controls. METHODS Five databases were searched from inception to January 2022. Observational studies comparing trunk kinematics or kinetics during weight-bearing tasks (e.g., stair negotiation, walking, running, landings) between individuals with knee disorders and controls were included. Meta-analyses for each knee disorder were performed. Outcome-level certainty was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), and evidence gap maps were created. RESULTS A total of 81 studies investigating trunk biomechanics across six different knee disorders were included (i.e., knee osteoarthritis [OA], total knee arthroplasty [TKA], patellofemoral pain [PFP], patellar tendinopathy [PT], anterior cruciate ligament deficiency [ACLD], and anterior cruciate ligament reconstruction [ACLR]). Individuals with knee OA presented greater trunk flexion during squatting (SMD 0.88, 95% CI 0.58-1.18) and stepping tasks (SMD 0.56, 95% CI 0.13-.99); ipsilateral and contralateral trunk lean during walking (SMD 1.36; 95% CI 0.60-2.11) and sit-to-stand (SMD 1.49; 95% CI 0.90-2.08), respectively. Greater trunk flexion during landing tasks in individuals with PFP (SMD 0.56; 95% CI 0.01-1.12) or ACLR (SMD 0.48; 95% CI 0.21-.75) and greater ipsilateral trunk lean during single-leg squat in individuals with PFP (SMD 1.01; 95% CI 0.33-1.70) were also identified. No alterations in trunk kinematics of individuals with TKA were identified. Evidence gap maps outlined the lack of investigations for individuals with PT or ACLD, as well as for trunk kinetics across knee disorders. CONCLUSION Individuals with knee OA, PFP, or ACLR present with altered trunk kinematics in the sagittal and frontal planes. The findings of this review support the assessment of trunk biomechanics in these individuals in order to identify possible targets for rehabilitation and avoidance strategies. TRIAL REGISTRATION PROSPERO registration number: CRD42019129257.
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Affiliation(s)
- Marina C. Waiteman
- grid.410543.70000 0001 2188 478XDepartment of Physical Therapy, School of Science and Technology, Sao Paulo State University (UNESP), 305, Roberto Simonsen Street, Presidente Prudente, Sao Paulo 19060-900 Brazil
| | - Lionel Chia
- grid.1013.30000 0004 1936 834XSydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia ,Cleveland Guardians Baseball Company, Cleveland, OH USA
| | - Matheus H. M. Ducatti
- grid.410543.70000 0001 2188 478XDepartment of Physical Therapy, School of Science and Technology, Sao Paulo State University (UNESP), 305, Roberto Simonsen Street, Presidente Prudente, Sao Paulo 19060-900 Brazil
| | - David M. Bazett-Jones
- grid.267337.40000 0001 2184 944XSchool of Exercise and Rehabilitation Sciences, College of Health and Human Services, University of Toledo, Toledo, OH USA
| | - Evangelos Pappas
- grid.1007.60000 0004 0486 528XSchool of Medicine and Illawarra Health and Medical Research Institute, The University of Wollongong, Wollongong, NSW Australia
| | - Fábio M. de Azevedo
- grid.410543.70000 0001 2188 478XDepartment of Physical Therapy, School of Science and Technology, Sao Paulo State University (UNESP), 305, Roberto Simonsen Street, Presidente Prudente, Sao Paulo 19060-900 Brazil
| | - Ronaldo V. Briani
- grid.410543.70000 0001 2188 478XDepartment of Physical Therapy, School of Science and Technology, Sao Paulo State University (UNESP), 305, Roberto Simonsen Street, Presidente Prudente, Sao Paulo 19060-900 Brazil
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Vincent HK, Vincent KR. Healthy Running Habits for the Distance Runner: Clinical Utility of the American College of Sports Medicine Infographic. Curr Sports Med Rep 2022; 21:463-469. [PMID: 36508604 DOI: 10.1249/jsr.0000000000001019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
ABSTRACT Healthy running form is characterized by motion that minimizes mechanical musculoskeletal injury risks and improves coactivation of muscles that can buffer impact loading and reduce stresses related to chronic musculoskeletal pain. The American College of Sports Medicine Consumer Outreach Committee recently launched an infographic that describes several healthy habits for the general distance runner. This review provides the supporting evidence, expected acute motion changes with use, and practical considerations for clinical use in patient cases. Healthy habits include: taking short, quick, and soft steps; abdominal bracing; elevating cadence; linearizing arm swing; controlling forward trunk lean, and; avoiding running through fatigue. Introduction of these habits can be done sequentially one at a time to build on form, or more than one over time. Adoption can be supported by various feedback forms and cueing. These habits are most successful against injury when coupled with regular dynamic strengthening of the kinetic chain, adequate recovery with training, and appropriate shoe wear.
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Affiliation(s)
- Heather K Vincent
- Department of Physical Medicine and Rehabilitation, UF Health Running Medicine and Sports Performance Center, College of Medicine, University of Florida, Gainesville, FL
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Elevated hip adduction angles and abduction moments in the gait of adolescents with recurrent patellar dislocation. Arch Orthop Trauma Surg 2022:10.1007/s00402-022-04703-y. [PMID: 36435929 DOI: 10.1007/s00402-022-04703-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/13/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Impaired hip kinematics and kinetics may incite patellar instability. This study tested the hypothesis that hip adduction and internal rotation angles during gait are higher in adolescents with recurrent patellar dislocations compared to healthy controls. MATERIAL AND METHODS Case-control study. Eighty-eight knees (67 patients) with recurrent patellar dislocation (mean age 14.8 years ± 2.8 SD) were compared to 54 healthy knees (27 individuals, 14.9 years ± 2.4 SD). Peak hip, knee and pelvis kinematics and kinetics were captured using 3D-gait analysis (VICON, 12 cameras, 200 Hz, Plug-in-Gait, two force plates) and compared between the two groups. One cycle (100%) consisted of 51 data points. The mean of six trials was computed. RESULTS Peak hip adduction angles and abduction moments were significantly higher in patients with recurrent patellar dislocation compared to the control group (p < 0.001 and 0.002, respectively). Peak internal hip rotation did not differ significantly. CONCLUSION Elevated hip adduction angles and higher hip abduction moments in gait of adolescents with recurrent patellar dislocation may indicate an impaired function of hip abductors that contributes to patellar instability.
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Valdir Briani R, Cannon J, Henrique Maiolini Ducatti M, Barbuglio Del Priore L, Flavia Balotari Botta A, Henrique Magalhães F, Mícolis de Azevedo F. Exacerbating patellofemoral pain alters trunk and lower limb coordination patterns and hip-knee mechanics. J Biomech 2022; 141:111215. [DOI: 10.1016/j.jbiomech.2022.111215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 11/30/2022]
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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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12
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Vincent HK, Brownstein M, Vincent KR. Injury Prevention, Safe Training Techniques, Rehabilitation, and Return to Sport in Trail Runners. Arthrosc Sports Med Rehabil 2022; 4:e151-e162. [PMID: 35141547 PMCID: PMC8811510 DOI: 10.1016/j.asmr.2021.09.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/22/2021] [Indexed: 12/31/2022] Open
Abstract
This current concept, narrative review provides the latest integrated evidence of the musculoskeletal injuries involved with trail running and therapeutic strategies to prevent injury and promote safe participation. Running activities that comprise any form of off-road running (trail running, orienteering, short-long distance, different terrain, and climate) are relevant to this review. Literature searches were conducted to 1) identify types and mechanisms of acute and chronic/overuse musculoskeletal injuries in trail runners, 2) injury prevention techniques most relevant to running trails, 3) safe methods of participation and rehabilitation timelines in the sport. The majority of acute and chronic trail running-related musculoskeletal injuries in trail running occur in the lower leg, primarily in the knee and ankle. More than 70% are due to overuse, and ankle sprains are the most common acute injury. Key mechanisms underlying injury and injury progression include inadequate neuromotor control-balance-coordination, running through fatigue, and abnormal kinematics on variable terrain. Complete kinetic chain prehabilitation programs consisting of dynamic flexibility, neuromotor strength and balance, and plyometrics exercise can foster stable, controlled movement on trails. Patient education about early musculoskeletal pain symptoms and training adjustment can help prevent injury from progressing to serious overuse injuries. Real-time adjustments to cadence, step length, and knee flexion on the trail may also mitigate impact-related risk for injury. After injury occurs, rehabilitation will involve similar exercise components, but it will also incorporate rest and active rest based on the type of injury. Multicomponent prehabilitation can help prevent musculoskeletal injuries in trail runners through movement control and fatigue resistance.
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Affiliation(s)
- Heather K Vincent
- Department of Physical Medicine and Rehabilitation, University of Florida College of Medicine, Gainesville, Florida, U.S.A
| | - Michael Brownstein
- Department of Physical Medicine and Rehabilitation, University of Florida College of Medicine, Gainesville, Florida, U.S.A
| | - Kevin R Vincent
- Department of Physical Medicine and Rehabilitation, University of Florida College of Medicine, Gainesville, Florida, U.S.A
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