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Heckelman LN, Kratzer AL, Spritzer CE, Soher BJ, Lewis BD, DeFrate LE. Influence of running on femoroacetabular joint bone-to-bone distances. J Orthop Res 2024; 42:837-842. [PMID: 37975269 DOI: 10.1002/jor.25735] [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: 06/06/2023] [Revised: 10/11/2023] [Accepted: 11/14/2023] [Indexed: 11/19/2023]
Abstract
There is limited data quantifying the influence of running on hip cartilage mechanics. The goal of this investigation was to quantify changes in hip joint bone-to-bone distance in response to a 3-mile treadmill run. We acquired magnetic resonance (MR) images of the dominant hip of eight young, asymptomatic runners (five males, three females) before and immediately after they ran 3 miles at a self-selected pace on a level treadmill. The femoral heads and acetabula were semiautomatically segmented from the pre- and post-exercise MR images to generate three-dimensional models of each participant's hip that were used to compute changes in the bone-to-bone distances incurred by the running exercise. We observed a significant 3% decrease in bone-to-bone distance from 3.47 ± 0.20 to 3.36 ± 0.22 mm between the femoral head and acetabulum after a 3-mile treadmill run (mean ± 95% confidence interval; p = 0.03). These findings provide new baseline data describing how running impacts the hip joint in young, asymptomatic runners.
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Affiliation(s)
- Lauren N Heckelman
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina, USA
| | - Avery L Kratzer
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina, USA
| | - Charles E Spritzer
- Department of Radiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Brian J Soher
- Department of Radiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Brian D Lewis
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Louis E DeFrate
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina, USA
- Department of Mechanical Engineering and Materials Science, Pratt School of Engineering, Duke University, Durham, North Carolina, USA
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Gille J, Reiss E, Behrens P, Jakob RP, Piontek T. Positive outcomes following Autologous Matrix-Induced Chondrogenesis (AMIC) in the treatment of retropatellar chondral lesions: a retrospective analysis of a patient registry. BMC Musculoskelet Disord 2023; 24:964. [PMID: 38082264 PMCID: PMC10712071 DOI: 10.1186/s12891-023-06923-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/25/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The patellofemoral joint is a challenging environment for treating chondral defects. Among the surgical options for the treatment of chondral defects, the single-stage Autologous Matrix-Induced Chondrogenesis (AMIC) procedure uses a porcine collagen I/III membrane to enhance bone-marrow stimulation. However, longer term outcomes data are rare for this specific indication. In order to provide real-world information, an ongoing registry has been established to record patient data and outcomes when AMIC is used to treat chondral and osteochondral lesions. METHODS Patient data were retrieved from an ongoing, prospective, multisite registry of patients who had undergone AMIC treatment of chondral defects. We identified 64 patients who had undergone AMIC for patellofemoral chondral defects and for whom pre-operative and at least 1 post-operative score were available were included in this retrospective data analysis. Outcomes were assessed via the KOOS, VAS pain, and the Lysholm scores. Outcomes at the post-operative time-points were analysed using a factorial ANOVA with post-hoc testing while linear regression was used to assess associations between the change in the Lysholm score and lesion size. RESULTS There was a significant improvement in Lysholm, VAS pain, and KOOS scores from pre-operative to the 1st year post-operative (p < 0.001), and this was maintained during the follow-up. CONCLUSIONS The forces exerted on the patellofemoral joint make this a challenging scenario for chondral repair. Our data demonstrates that the AMIC procedure with a collagen I/III membrane is an effective treatment for retropatellar cartilage lesions, and provides reliable results, with decreased pain and improved function. Importantly, these improvements were maintained through the follow-up period.
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Affiliation(s)
- J Gille
- Universitätsklinikum Schleswig-Holstein - Campus Lübeck, Lübeck, Germany.
| | - E Reiss
- OrthoPraxis, Zofingen, Switzerland
| | - P Behrens
- ORTHODOK, Tonndorfer Hauptstraße 71, 22045, Hamburg, Germany
| | - R P Jakob
- Orthopaedic Department Kantonsspital Fribourg, University of Berne, Bern, Switzerland
| | - T Piontek
- Department of Spine Disorders and Pediatric Orthopedics, University of Medical Sciences, Poznan, Poland
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Soke F, Aydin F, Karakoc S, Gulsen C, Yasa ME, Ersoy N, Gulsen EO, Yucesan C. Effects of backward walking training on balance, gait, and functional mobility in people with multiple sclerosis: A randomized controlled study. Mult Scler Relat Disord 2023; 79:104961. [PMID: 37683559 DOI: 10.1016/j.msard.2023.104961] [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: 05/03/2023] [Revised: 08/04/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Backward walking training (BWT) can have a positive effect on balance, gait, and functional mobility in neurological diseases; however, the effectiveness of BWT has not been examined in multiple sclerosis (MS). Therefore, the study aimed to investigate the effects of BWT on balance, gait, and functional mobility in people with MS (PwMS). METHOD Nineteen PwMS were randomly allocated to either the experimental group (n=10) and the control group (n=9). The experimental group received BWT in addition to conventional walking training (CWT) while the control group only received CWT. Both groups performed training three times a week for 8 weeks. Participants were assessed with the Berg Balance Scale (BBS), four square step test (FSST), activities-specific balance confidence scale (ABC), timed 25-foot walk test (T25FW), dynamic gait index (DGI), 3-meter backward walk test (3MBWT), Multiple Sclerosis Walking Scale-12 (MSWS-12), and timed up and go test (TUG) before and after training. RESULTS After training, both groups showed significant improvements on the T25FW, and TUG (p<0.05) while only the experimental group showed significant improvements on the BBS, FSST, ABC, DGI, 3MBWT, and MSWS-12 (p<0.05). The experimental group significantly improved more than the control group in all outcomes (p<0.05) except for the T25FW (p=0.202). CONCLUSION BWT in addition to CWT is an effective way to improve balance, gait, and functional mobility for PwMS. These results suggest that BWT may be a potentially useful treatment approach when added to CWT in the rehabilitation of MS.
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Affiliation(s)
- Fatih Soke
- University of Health Sciences, Gulhane Faculty of Physiotherapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, Ankara, Turkey.
| | - Fatma Aydin
- University of Health Sciences, Ankara Etlik City Hospital, Department of Neurology, Ankara, Turkey
| | - Selda Karakoc
- Ankara Yildirim Beyazit University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara, Turkey
| | - Cagri Gulsen
- Osmangazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Eskisehir, Turkey
| | - Mustafa Ertugrul Yasa
- University of Health Sciences, Gulhane Faculty of Physiotherapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, Ankara, Turkey
| | - Nursena Ersoy
- Ankara University, Faculty of Health Sciences, Department of Nutrition and Dietetic, Ankara, Turkey
| | - Elvan Ozcan Gulsen
- Anadolu University, Vocational School of Health Services, Elderly Care Program, Eskisehir, Turkey
| | - Canan Yucesan
- Ankara University, Faculty of Medicine, Department of Neurology, Ankara, Turkey
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Esculier JF, Bouyer LJ, Roy JS. Running gait modifications can lead to immediate reductions in patellofemoral pain. Front Sports Act Living 2023; 4:1048655. [PMID: 36726397 PMCID: PMC9884822 DOI: 10.3389/fspor.2022.1048655] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/30/2022] [Indexed: 01/18/2023] Open
Abstract
Gait modifications are commonly advocated to decrease knee forces and pain in runners with patellofemoral pain (PFP). However, it remains unknown if clinicians can expect immediate effects on symptoms. Our objectives were (1) to compare the immediate effects of gait modifications on pain and kinetics of runners with PFP; (2) to compare kinetic changes in responders and non-responders; and (3) to compare the effects between rearfoot strikers (RFS) and non-RFS. Sixty-eight runners with PFP (42 women, 26 men) ran normally on a treadmill before testing six modifications: 1- increase step rate by 10%; 2- 180 steps per minute; 3- decrease step rate by 10%; 4- forefoot striking; 5- heel striking; 6- running softer. Overall, there were more responders (pain decreased ≥1/10 compared with normal gait) during forefoot striking and increasing step rate by 10% (both 35%). Responders showed greater reductions in peak patellofemoral joint force than non-responders during all conditions except heel striking. When compared with non-RFS, RFS reduced peak patellofemoral joint force in a significant manner (P < 0.001) during forefoot striking (partial η 2 = 0.452) and running softer (partial η 2 = 0.302). Increasing step rate by 10% reduced peak patellofemoral joint force in both RFS and non-RFS. Forty-two percent of symptomatic runners reported immediate reductions in pain during ≥1 modification, and 28% had reduced pain during ≥3 modifications. Gait modifications leading to decreased patellofemoral joint forces may be associated with immediate pain reductions in runners with PFP. Other mechanisms may be involved, given that some runners reported decreased symptoms regardless of kinetic changes.
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Affiliation(s)
- Jean-Francois Esculier
- The Running Clinic, Lac beauport, QC, Canada,Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada,MoveMed Physiotherapy, Kelowna, BC, Canada,Correspondence: Jean-Francois Esculier
| | - Laurent J. Bouyer
- Faculty of Medicine, Université Laval, Quebec, QC, Canada,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada
| | - Jean-Sébastien Roy
- Faculty of Medicine, Université Laval, Quebec, QC, Canada,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada
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Ertman B, Dade R, Vannatta CN, Kernozek TW. Offloading Effects on Impact Forces and Patellofemoral Joint Loading During Running in Females. Gait Posture 2022; 93:212-217. [PMID: 35183838 DOI: 10.1016/j.gaitpost.2022.02.013] [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: 05/13/2021] [Revised: 02/07/2022] [Accepted: 02/12/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Structure-specific loading is being increasingly recognized as playing a role in running related injuries. The use of interventions targeted at reducing patellofemoral joint loads have shown effectiveness in reducing symptoms of patellofemoral pain. Use of bodyweight support (BWS) has the potential to reduce loading on the patellofemoral joint during running to augment rehabilitation efforts. RESEARCH QUESTION How is patellofemoral joint loading different when using a harness-based BWS system during running? METHODS Twenty-five healthy females free from lower extremity injury were included. Participants completed four running trials on an instrumented treadmill with varying amounts of BWS using a commercially available harness system. Kinematic data from a 3D motion capture system and kinetic data from the treadmill were combined in a computer model to estimate measures of patellofemoral joint loading, knee kinematics, ground reaction force, and stride frequency. RESULTS Peak patellofemoral joint stress and time-integral were reduced when running under BWS conditions compared to control conditions. Incremental decreases in patellofemoral loading were not observed with incremental increases in BWS. Peak knee flexion angle was reduced in all BWS conditions compared to control but was not different between BWS conditions. Knee flexion excursion was reduced in only the high BWS condition. Peak ground reaction force and stride frequency incrementally decreased with increased amounts of BWS. SIGNIFICANCE Harness-based BWS systems may provide a simple means to reduce patellofemoral joint loading to assist in rehabilitation efforts, such as addressing patellofemoral pain.
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Affiliation(s)
- Bryce Ertman
- Department of Health Professions, Physical Therapy Program, University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States; La Crosse Institute for Movement Science (LIMS), University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States
| | - Renee Dade
- Department of Health Professions, Physical Therapy Program, University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States; La Crosse Institute for Movement Science (LIMS), University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States
| | - C N Vannatta
- La Crosse Institute for Movement Science (LIMS), University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States; Gundersen Health System, Sports Medicine Department, 311 Gundersen Drive, Onalaska, WI, United States
| | - Thomas W Kernozek
- Department of Health Professions, Physical Therapy Program, University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States; La Crosse Institute for Movement Science (LIMS), University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States.
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Hart HF, Patterson BE, Crossley KM, Culvenor AG, Khan MCM, King MG, Sritharan P. May the force be with you: understanding how patellofemoral joint reaction force compares across different activities and physical interventions-a systematic review and meta-analysis. Br J Sports Med 2022; 56:521-530. [PMID: 35115309 DOI: 10.1136/bjsports-2021-104686] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To systematically review and synthesise patellofemoral joint reaction force (PFJRF) in healthy individuals and those with patellofemoral pain and osteoarthritis (OA), during everyday activities, therapeutic exercises and with physical interventions (eg, foot orthotics, footwear, taping, bracing). DESIGN A systematic review with meta-analysis. DATA SOURCES Medline, Embase, Scopus, CINAHL, SportDiscus and Cochrane Library databases were searched. ELIGIBILITY CRITERIA Observational and interventional studies reporting PFJRF during everyday activities, therapeutic exercises, and physical interventions. RESULTS In healthy individuals, the weighted average of mean (±SD) peak PFJRF for everyday activities were: walking 0.9±0.4 body weight (BW), stair ascent 3.2±0.7 BW, stair descent 2.8±0.5 BW and running 5.2±1.2 BW. In those with patellofemoral pain, peak PFJRF were: walking 0.8±0.2 BW, stair ascent 2.5±0.5 BW, stair descent 2.6±0.5 BW, running 4.1±0.9 BW. Only single studies reported peak PFJRF during everyday activities in individuals with patellofemoral OA/articular cartilage defects (walking 1.3±0.5 BW, stair ascent 1.6±0.4 BW, stair descent 1.0±0.5 BW). The PFJRF was reported for many different exercises and physical interventions; however, considerable variability precluded any pooled estimates. SUMMARY Everyday activities and exercises involving larger knee flexion (eg, squatting) expose the patellofemoral joint to higher PFJRF than those involving smaller knee flexion (eg, walking). There were no discernable differences in peak PFJRF during everyday activities between healthy individuals and those with patellofemoral pain/OA. The information on PFJRF may be used to select appropriate variations of exercises and physical interventions.
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Affiliation(s)
- Harvi F Hart
- La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia .,Department of Physical Therapy, Western University, London, Ontario, Canada
| | - Brooke E Patterson
- La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Kay M Crossley
- La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Adam G Culvenor
- La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Michaela C M Khan
- Motion Analysis and Biofeedback Laboratory, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Matthew G King
- La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Prasanna Sritharan
- La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
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Yun SH, Cho MJ, Kwon JW. Comparison of forward versus backward walking on spatiotemporal and kinematic parameters on sand: A preliminary study. J Biomech 2021; 130:110876. [PMID: 34871892 DOI: 10.1016/j.jbiomech.2021.110876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 11/09/2021] [Accepted: 11/22/2021] [Indexed: 01/17/2023]
Abstract
The purpose of this study was to investigate the spatiotemporal and kinematic parameters of backward walking (BW) and forward walking (FW) on sand. Randomly selected subjects (n = 28) were categorized into a sand group (SG, n = 14) and an overground group (OG, n = 14). SG was directed to perform both FW and BW on sand, while OG performed the same on the overground. Spatiotemporal and kinematic parameters were measured using the LegSys + device. The comparative findings of both the groups showed that the spatiotemporal parameters of SG varied significantly from those of OG in both FW and BW conditions (p < 0.05). The kinematic parameters varied significantly between the two groups only in the FW condition (p < 0.05). When compared within each group, spatiotemporal and kinematic parameters in the BW condition were significantly different from those in the FW condition. However, the percentages of stance, swing, and double support were not significantly different between FW and BW conditions (p > 0.05). This study suggests that sand walking is associated with a different gait pattern than overground walking, as evident from the analysis of the results of spatiotemporal and kinematic parameters in both FW and BW conditions. Therefore, sand walking can be used as a new approach to gait and balance training in clinical practice.
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Affiliation(s)
- Seong Ho Yun
- Department of Physical Therapy, College of Health Sciences, Dankook University, Republic of Korea
| | - Min Jye Cho
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Republic of Korea
| | - Jung Won Kwon
- Department of Physical Therapy, College of Health Sciences, Dankook University, Republic of Korea.
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A Backward Walking Training Program to Improve Balance and Mobility in Children with Cerebral Palsy. Healthcare (Basel) 2021; 9:healthcare9091191. [PMID: 34574964 PMCID: PMC8465093 DOI: 10.3390/healthcare9091191] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/05/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background: We studied the effects of motor tasks using backward walking training on balance and gait functions of children with cerebral palsy. This was a single-blinded, randomized controlled trial with a crossover design conducted at a single facility. Methods: Among 12 children with cerebral palsy, the forward (FWG) (n = 6) and backward walking groups (BWG) (n = 6) underwent training three times a week for 4 weeks, 40 min a day. After a 6-week break, the crossover training was conducted. Functional walking variables were measured. Time-Up-and-Go (TUG) test, Figure-8 Walk Test (FW8T), and Pediatric Balance Scale (PBS) were used for measuring balance. Results: Both groups showed significant improvement in walking speed, stride length, and step length. The BWG demonstrated significant improvement in walking speed (p < 0.05) compared with the FWG. The TUG test, FW8T, and PBS showed significant improvement. After the 4-week intervention, both groups displayed a remarkable decrease in TUG duration and FW8T. Both groups also exhibited improvement in the PBS; more so in the BWG. Conclusions: Backward walking training with motor dual tasks could be a more effective interventional approach than forward walking training to improve balance and walking functions of children with spastic hemiplegia.
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Uthoff A, Zois J, Van Den Tillaar R, Nagahara R. Acceleration mechanics during forward and backward running: A comparison of step kinematics and kinetics over the first 20 m. J Sports Sci 2021; 39:1816-1821. [PMID: 33711913 DOI: 10.1080/02640414.2021.1898193] [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: 10/21/2022]
Abstract
Backward running (BR) and forward running (FR) are unique movements utilized by athletes in many sports. Importantly, this investigation provides further insights on BR and benchmarking against more commonly researched FR capacity. Twenty-one collegiate soccer players (age 20.0 ± 0.8 years, body mass 65.6 ± 7.7 kg, body height 1.70 ± 0.07 m) performed maximal effort BR and FR along 20 m of in-ground force platforms. Step kinematics and kinetics were compared between BR and FR over four relative acceleration phases (BR = steps 1-6, 7-12, 13-18 and 19-23; FR = steps 1-4, 5-8, 9-12, 13-15). The primary findings of this study were that BR speeds were 29% slower than FR (p < 0.001), all step kinematics differed between BR and FR (p < 0.01), except contact time from the second to fourth step phases (p > 0.05), and most step kinetics were lower during BR (p < 0.05), with the exceptions of peak vertical force (p > 0.05). These findings indicate that lower running speeds over the acceleration phases of BR appear to be primarily due to lower horizontal ground reaction force application, resulting in shorter stride lengths and decreased flight times compared to FR.
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Affiliation(s)
- Aaron Uthoff
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - James Zois
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | | | - Ryu Nagahara
- National Institute of Fitness and Sports in Kanoya, Kanoya, Japan
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Kauffman AP, Araujo GHOD, Manoel FDA, Peserico CS, Machado FA. Effects of a backward running training on backward peak velocity running, V̇O2max, vVO2max and 3 km forward running performance in male adults: a pilot study. MOTRIZ: REVISTA DE EDUCACAO FISICA 2021. [DOI: 10.1590/s1980-65742021016420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Rasica L, Porcelli S, Minetti AE, Pavei G. Biomechanical and metabolic aspects of backward (and forward) running on uphill gradients: another clue towards an almost inelastic rebound. Eur J Appl Physiol 2020; 120:2507-2515. [PMID: 32840696 PMCID: PMC7557486 DOI: 10.1007/s00421-020-04474-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/10/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE On level, the metabolic cost (C) of backward running is higher than forward running probably due to a lower elastic energy recoil. On positive gradient, the ability to store and release elastic energy is impaired in forward running. We studied running on level and on gradient to test the hypothesis that the higher metabolic cost and lower efficiency in backward than forward running was due to the impairment in the elastic energy utilisation. METHODS Eight subjects ran forward and backward on a treadmill on level and on gradient (from 0 to + 25%, with 5% step). The mechanical work, computed from kinematic data, C and efficiency (the ratio between total mechanical work and C) were calculated in each condition. RESULTS Backward running C was higher than forward running at each condition (on average + 35%) and increased linearly with gradient. Total mechanical work was higher in forward running only at the steepest gradients, thus efficiency was lower in backward running at each gradient. CONCLUSION Efficiency decreased by increasing gradient in both running modalities highlighting the impairment in the elastic contribution on positive gradient. The lower efficiency values calculated in backward running in all conditions pointed out that backward running was performed with an almost inelastic rebound; thus, muscles performed most of the mechanical work with a high metabolic cost. These new backward running C data permit, by applying the recently introduced 'equivalent slope' concept for running acceleration, to obtain the predictive equation of metabolic power during level backward running acceleration.
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Affiliation(s)
- L Rasica
- Institute of Biomedical Technologies, National Research Council, Segrate, Italy
| | - S Porcelli
- Institute of Biomedical Technologies, National Research Council, Segrate, Italy
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - A E Minetti
- Laboratory of Physiomechanics of Locomotion, Department of Pathophysiology and Transplantation, Physiology Division, University of Milan, Via Mangiagalli 32, 20133, Milan, Italy
| | - G Pavei
- Laboratory of Physiomechanics of Locomotion, Department of Pathophysiology and Transplantation, Physiology Division, University of Milan, Via Mangiagalli 32, 20133, Milan, Italy.
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Mackay GJK, Stearne SM, Wild CY, Nugent EP, Murdock AP, Mastaglia B, Hall TM. Mulligan Knee Taping Using Both Elastic and Rigid Tape Reduces Pain and Alters Lower Limb Biomechanics in Female Patients With Patellofemoral Pain. Orthop J Sports Med 2020; 8:2325967120921673. [PMID: 32528991 PMCID: PMC7263138 DOI: 10.1177/2325967120921673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 02/01/2020] [Indexed: 01/22/2023] Open
Abstract
Background: Evidence supports the use of Mulligan knee taping in managing patellofemoral pain (PFP). However, no studies have compared the efficacy of rigid and elastic tape using this technique. Hypothesis: Mulligan knee taping applied with both rigid and elastic tape will produce similar reductions in knee pain, hip internal rotation, and knee flexion moments compared with no tape. Elastic tape will also be more comfortable than rigid tape. Study Design: Controlled laboratory study. Methods: A total of 19 female patients (mean age, 26.5 ± 4.5 years) with PFP performed a self-selected pain provocative task, single-leg squat (SLSq) task, and running task while wearing Mulligan knee taping applied with rigid tape, elastic tape at 100% tension, and no tape. Pain and taping comfort were recorded using 11-point numeric rating scales. An 18-camera motion capture system and in-ground force plates recorded 3-dimensional lower limb kinematics and kinetics for the SLSq and running tasks. Statistical analysis involved a series of repeated-measures analyses of variance. The Wilcoxon signed rank test was used for analyzing taping comfort. Results: Compared with no tape, both rigid and elastic tape significantly reduced pain during the pain provocative task (mean difference [MD], –0.97 [95% CI, –1.57 to –0.38] and –1.42 [95% CI, –2.20 to –0.64], respectively), SLSq (MD, –1.26 [95% CI, –2.23 to –0.30] and –1.13 [95% CI, –2.09 to –0.17], respectively), and running tasks (MD, –1.24 [95% CI, –2.11 to –0.37] and –1.16 [95% CI, –1.86 to –0.46], respectively). Elastic tape was significantly more comfortable than rigid tape generally (P = .005) and during activity (P = .022). Compared with no tape, both rigid and elastic tape produced increased knee internal rotation at initial contact during the running task (MD, 5.5° [95% CI, 3.6° to 7.4°] and 5.9° [95% CI, 3.9° to 7.9°], respectively) and at the commencement of knee flexion during the SLSq task (MD, 5.8° [95% CI, 4.5° to 7.0°] and 5.8° [95% CI, 4.1° to 7.4°], respectively), greater peak knee internal rotation during the running (MD, 1.8° [95% CI, 0.4° to 3.3°] and 2.2° [95% CI, 0.9° to 3.6°], respectively) and SLSq tasks (MD, 3.2° [95% CI, 2.1° to 4.3°] and 3.8° [95% CI, 2.3° to 5.2°], respectively), and decreased knee internal rotation range of motion during the running (MD, –3.6° [95% CI, –6.1° to –1.1°] and –3.7° [95% CI, –6.2° to –1.2°], respectively) and SLSq tasks (MD, –2.5° [95% CI, –3.9° to –1.2°] and –2.0° [95% CI, –3.2° to –0.9°], respectively). Conclusion: Mulligan knee taping with both rigid and elastic tape reduced pain across all 3 tasks and altered tibiofemoral rotation during the SLSq and running tasks. Clinical Relevance: Both taping methods reduced pain and altered lower limb biomechanics. Elastic tape may be chosen clinically for comfort reasons.
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Affiliation(s)
- Grant J K Mackay
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Sarah M Stearne
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Catherine Y Wild
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Erin P Nugent
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Alexander P Murdock
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Benjamin Mastaglia
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Toby M Hall
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
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Sritharan P, Schache AG, Culvenor AG, Perraton LG, Bryant AL, Crossley KM. Between-Limb Differences in Patellofemoral Joint Forces During Running at 12 to 24 Months After Unilateral Anterior Cruciate Ligament Reconstruction. Am J Sports Med 2020; 48:1711-1719. [PMID: 32374673 DOI: 10.1177/0363546520914628] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Patellofemoral joint (PFJ) osteoarthritis may occur after anterior cruciate ligament reconstruction (ACLR). The mechanisms underpinning the development of PFJ osteoarthritis are not known but may relate to altered PFJ loading. Few studies have assessed PFJ loads during high-impact tasks, such as running, beyond the acute rehabilitation phase (ie, >12 months) after ACLR. PURPOSE/HYPOTHESIS The purpose was to compare between-limb joint angles, joint moments, and PFJ contact force during running in individuals at 12 to 24 months after unilateral ACLR. We hypothesized that peak knee flexion angle, knee extension moment, and PFJ contact force during stance would be lower in the ACLR limb compared with the uninjured limb. STUDY DESIGN Controlled laboratory study. METHODS A total of 55 participants (mean ± SD age, 28 ± 7 years), 12 to 24 months after ACLR, ran at a self-selected speed (2.9 ± 0.3 m/s). Measured kinematics and ground-reaction forces were input into musculoskeletal models to calculate joint moments and muscle forces. These values were subsequently input into a PFJ model to calculate contact force peak and impulse. Outcome measures were compared between the ACLR and uninjured limbs. RESULTS In the ACLR limb, compared with the uninjured limb, the PFJ contact force displayed a lower peak (ACLR, 6.1 ± 1.3 body weight [BW]; uninjured, 6.7 ± 1.4 BW; P < .001) and impulse (ACLR, 0.72 ± 0.17 BW*seconds [BWs]; uninjured, 0.81 ± 0.17 BWs; P < .001). At the time of the peak PFJ contact force, the knee extension moment was lower in the ACLR limb (ACLR, 14.0 ± 2.4 %BW*height [%BW*HT]; uninjured, 15.5 ± 2.5 %BW*HT; P < .001). The opposite was true for the ankle plantarflexion moment (ACLR, 12.1 ± 2.6 %BW*HT; uninjured, 11.5 ± 2.7 %BW*HT; P = .019) and the hip extension moment (ACLR, 2.3 ± 2.5 %BW*HT; uninjured, 1.6 ± 2.3 %BW*HT; P = .013). The foot-ground center of pressure was located more anteriorly with respect to the ankle joint center (ACLR, 5.8 ± 0.9 %height [%HT]; uninjured, 5.4 ± 1.0 %HT; P = .001). No differences were found for the sagittal plane hip, knee, and ankle angles. CONCLUSION The ACLR limb experienced lower peak PFJ loads during running, explained by a small anterior shift in the foot-ground center of pressure during stance that offloaded the torque demand away from the ACLR knee. CLINICAL RELEVANCE Lower net PFJ loading during running in the ACLR limb more than 12 months after ACLR suggests that underloading might play a role in the onset of PFJ osteoarthritis after ACLR.
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Affiliation(s)
| | | | - Adam G Culvenor
- School of Allied Health, La Trobe University, Victoria, Australia
| | - Luke G Perraton
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Adam L Bryant
- Centre for Health, Exercise & Sports Medicine, University of Melbourne, Victoria, Australia
| | - Kay M Crossley
- School of Allied Health, La Trobe University, Victoria, Australia
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Backward Running: Acute Effects on Sprint Performance in Preadolescent Boys. Sports (Basel) 2020; 8:sports8040055. [PMID: 32340126 PMCID: PMC7240527 DOI: 10.3390/sports8040055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/12/2020] [Accepted: 04/20/2020] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to examine the acute effect of backward running (BwR) during warm-up on a 20-m sprint of boys’ performance, compared to forward running (FwR). Fourteen recreationally active preadolescent boys (aged 12.5 ± 0.5 years) were examined in 3 protocols: warm-up (control condition), warm-up with 3 × 10 m additional BwR sprints and warm-up with 3 × 10 m additional FwR sprints. Participants were evaluated 4 minutes after each protocol on a 20-m sprint and intermediate distances, as well as the rate of perceived exertion (RPE). Sprint speed across 10-20 m was significantly higher for the BwR warm-up compared to the regular warm-up (p < 0.05) and a significantly higher RPE after the BwR and FwR protocols compared to the control condition was recorded (p < 0.05). No significant difference was detected across the distances 0–5, 5–10, 0–10 and 0–20 m. Although adding 3 × 10-m sprints of BwR or FwR after the warm-up did not enhance performance in a 20 m sprint of preadolescent boys, the positive effect of BwR across 10–20 m distance suggests that BwR could be an alternative means for enhancing performance for certain phases of a sprint for this age. However, preadolescent boys’ response to different sprint conditioning exercise stimuli and the optimization of rest time to maximize performance remain to be determined.
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Uthoff A, Oliver J, Cronin J, Harrison C, Winwood P. Sprint-Specific Training in Youth: Backward Running vs. Forward Running Training on Speed and Power Measures in Adolescent Male Athletes. J Strength Cond Res 2020; 34:1113-1122. [DOI: 10.1519/jsc.0000000000002914] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Uthoff A, Oliver J, Cronin J, Winwood P, Harrison C. Backward Running: The Why and How to Program for Better Athleticism. Strength Cond J 2019. [DOI: 10.1519/ssc.0000000000000459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Backward walking alters vastus medialis oblique/vastus lateralis muscle activity ratio in females with patellofemoral pain syndrome. Turk J Phys Med Rehabil 2019; 65:169-176. [PMID: 31453558 DOI: 10.5606/tftrd.2019.2445] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 05/22/2018] [Indexed: 12/11/2022] Open
Abstract
Objectives This study aims to examine the effect of backward walking (BW) and forward walking (FW) on the myoelectric activity ratio of the vastus medialis oblique (VMO)/vastus lateralis (VL) in females with patellofemoral pain syndrome (PFPS). Patients and methods Between September 2016 and December 2016, a total of 40 female participants (mean age 20.9±1.9 years; range, 19 to 26 years) were included in the study. The participants were divided into two groups as those with unilateral PFPS (PFPS group, n=20) and healthy controls (Control group, n=20). Surface electromyography (EMG) from VMO and VL muscles were collected during FW and BW at a speed of 3 km/h using the Myomonitor® IV EMG system. Results There was a significant increase in the EMG activities of the VMO and VL muscles during BW compared to FW in PFPS and healthy groups (p=0.001). During BW, the VMO activity of PFPS was significantly higher than the healthy controls (p=0.013) without any significant difference in the VL activity (p=0.916). During FW, there was no significant difference in the VMO and VL activities between the groups (p=0.348 and p=0.705), respectively. The VMO/VL ratio of the PFPS group during BW was significantly higher than the FW ratio (p=0.001) without any significant difference between BW and FW of the healthy group (p=0.841). During BW, the ratio of the PFPS group was significantly higher than compared to the healthy controls (p=0.016) without any significant difference between the groups during FW (p=0.100). Conclusion Our study results show that BW increases the VMO muscle activation and preserve the ideal VMO/VL ratio in PFPS patients. Therefore, clinicians should consider BW training when developing rehabilitation programs for females with PFPS.
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Effectiveness of backward walking training on balance performance: A systematic review and meta-analysis. Gait Posture 2019; 68:466-475. [PMID: 30616175 DOI: 10.1016/j.gaitpost.2019.01.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 12/30/2018] [Accepted: 01/01/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Backward walking (BW) training is thought to impact balance performance through improving motor system proprioception and gait characteristic, but relevant evidence remains sparse and inconclusive. OBJECTIVE This study systematically reviewed and quantified the scientific evidence regarding the effectiveness of BW training on balance performance. METHODS Keyword and reference search on BW training interventions was conducted in six electronic databases (PubMed, Web of science, SPORTDiscus, CINAHL, Cochrane Library, and CNKI) for peer-reviewed articles published till November 2017. A standardized form was used to extract data from each selected article that met the pre-specified eligibility criteria. Meta-analysis was conducted to estimate the pooled effects of BW training on balance performance measures. RESULTS Eleven studies (nine randomized controlled trials and two pre-post studies) met the eligibility criteria and were included in the review. All studies reported some beneficial effects of BW training on balance performance. Compared to control, BW training was associated with a reduction in overall stability index score by 0.99 (95% CI = 0.37, 1.61; I2 = 0.0%; fixed-effect model), medial-lateral stability index score by 0.95 (95% CI = 0.34, 1.57; I2 = 0.0%; fixed-effect model), and anterior-posterior stability index score by 0.99 (95% CI = 0.37, 1.61; I2 = 0.0%; fixed-effect model). Meanwhile, BW training was associated with an increase in open-eyes single leg standing duration by 0.91 s (95% CI = 0.29, 1.53; I2 = 75.9%; random-effect model) in comparison to control. CONCLUSIONS BW training could serve as a potentially useful tool to improve balance performance among those with a high risk of fall. However, current evidence remains preliminary due to the small cohort of studies and possible learning effect in pre-post studies. Future work with larger scale and randomized experimental design is warranted to evaluate the effectiveness of BW training on balance performance across diverse population and disease subgroups, and elucidate the underlying biomechanical and neurological pathways.
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Abdelraouf OR, Abdel-Aziem AA, Ahmed AA, Nassif NS, Matar AG. Backward walking effects on activation pattern of leg muscles in young females with patellofemoral pain syndrome. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2019. [DOI: 10.12968/ijtr.2017.0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims: Little is known regarding the activation of knee and hip muscles during backward walking in patellofemoral pain syndrome. This study examineD the effects of backward walking and forward walking on the activation of knee extensors, hip abductors, and adductors in patients with patellofemoral pain syndrome. Methods: A total of 20 females with patellofemoral pain syndrome and 20 age-matched typically healthy female controls participated in this study. Surface electromyography from vastus medialis obliquus, vastus lateralis, gluteus medius, and adductor longus muscles were collected during forward walking and backward walking. Findings: The patellofemoral pain syndrome group had a significantly higher normalised root mean square of the vastus medialis obliquus, vastus lateralis and gluteus medius muscles (P=0.001), without significant difference in adductor longus muscle activity during backward walking versus forward walking (P=0.098). During forward walking, the patellofemoral pain syndrome group showed significantly higher activation of adductor longus muscle (P=0.001) and significantly lower activation of the gluteus medius muscle (P=0.002) compared to the healthy group. During backward walking there was a significant increase in the vastus medialis obliquus and adductor longus muscle activity of the patellofemoral pain syndrome group compared to the control group (P=0.003, 0.001) respectively. Conclusions: Clinicians should consider backward walking training to increase the muscle strength of knee extensors and hip abductors when developing rehabilitation programmes for patients with patellofemoral pain syndrome.
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Affiliation(s)
- Osama R Abdelraouf
- Assistant professor, Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Amr A Abdel-Aziem
- Professor, Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Alaa A Ahmed
- Assistant Lecturer, Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Nagui S Nassif
- Professor, Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ayman G Matar
- Lecturer, Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Uthoff A, Oliver J, Cronin J, Harrison C, Winwood P. A New Direction to Athletic Performance: Understanding the Acute and Longitudinal Responses to Backward Running. Sports Med 2018; 48:1083-1096. [PMID: 29498028 DOI: 10.1007/s40279-018-0877-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Backward running (BR) is a form of locomotion that occurs in short bursts during many overground field and court sports. It has also traditionally been used in clinical settings as a method to rehabilitate lower body injuries. Comparisons between BR and forward running (FR) have led to the discovery that both may be generated by the same neural circuitry. Comparisons of the acute responses to FR reveal that BR is characterised by a smaller ratio of braking to propulsive forces, increased step frequency, decreased step length, increased muscle activity and reliance on isometric and concentric muscle actions. These biomechanical differences have been critical in informing recent scientific explorations which have discovered that BR can be used as a method for reducing injury and improving a variety of physical attributes deemed advantageous to sports performance. This includes improved lower body strength and power, decreased injury prevalence and improvements in change of direction performance following BR training. The current findings from research help improve our understanding of BR biomechanics and provide evidence which supports BR as a useful method to improve athlete performance. However, further acute and longitudinal research is needed to better understand the utility of BR in athletic performance programs.
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Affiliation(s)
- Aaron Uthoff
- Sports Performance Research Institute New Zealand (SPRINZ), AUT Millennium, AUT University, Auckland, New Zealand.
| | - Jon Oliver
- Sports Performance Research Institute New Zealand (SPRINZ), AUT Millennium, AUT University, Auckland, New Zealand.,Youth Physical Development Unit, School of Sport, Cardiff Metropolitan University, Cyncoed Campus, Cyncoed Road, Cardiff, CF23 6XD, UK
| | - John Cronin
- Sports Performance Research Institute New Zealand (SPRINZ), AUT Millennium, AUT University, Auckland, New Zealand.,School of Health and Medical Science, Edith Cowan University, Perth, WA, Australia
| | - Craig Harrison
- Sports Performance Research Institute New Zealand (SPRINZ), AUT Millennium, AUT University, Auckland, New Zealand
| | - Paul Winwood
- Sports Performance Research Institute New Zealand (SPRINZ), AUT Millennium, AUT University, Auckland, New Zealand.,Department of Sport and Recreation, School of Applied Science, Toi Ohomai Institute of Technology, Tauranga, New Zealand
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Effectiveness of backward walking training on spatial-temporal gait characteristics: A systematic review and meta-analysis. Hum Mov Sci 2018; 60:57-71. [DOI: 10.1016/j.humov.2018.05.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 12/25/2022]
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Masumoto K, Soucy MT, Bailey JP, Mercer JA. Muscle activity during backward and forward running with body weight support. Hum Mov Sci 2017; 55:276-286. [DOI: 10.1016/j.humov.2017.08.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 08/18/2017] [Accepted: 08/21/2017] [Indexed: 10/18/2022]
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Mestelle Z, Kernozek T, Adkins KS, Miller J, Gheidi N. EFFECT OF HEEL LIFTS ON PATELLOFEMORAL JOINT STRESS DURING RUNNING. Int J Sports Phys Ther 2017; 12:711-717. [PMID: 29181248 PMCID: PMC5685409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Patellofemoral pain is a debilitating injury for many recreational runners. Excessive patellofemoral joint stress may be the underlying source of pain and interventions often focus on ways to reduce patellofemoral joint stress. PURPOSE Heel lifts have been used as an intervention within Achilles tendon rehabilitation programs and to address leg length discrepancies. The purpose of this study was to examine the effect of running with heel lifts on patellofemoral joint stress, patellofemoral stress impulse, quadriceps force, step length, cadence, and other related kinematic and spatiotemporal variables. STUDY DESIGN A repeated-measures research design. METHODS Sixteen healthy female runners completed five running trials in a controlled laboratory setting with and without 11mm heel lifts inserted in a standard running shoe. Kinetic and kinematic data were used in combination with a static optimization technique to estimate individual muscle forces. These data were inserted into a patellofemoral joint model which was used to estimate patellofemoral joint stress and other variables during running. RESULTS When running with heel lifts, peak patellofemoral joint stress and patellofemoral stress impulse were reduced by a 4.2% (p=0.049) and 9.3% (p=0.002). Initial center of pressure was shifted anteriorly 9.1% when running with heel lifts (p<0.001) despite all runners utilizing a heel strike pattern. Dorsiflexion at initial contact was reduced 28% (p=0.016) when heel lifts were donned. No differences in step length and cadence (p>0.05) were shown between conditions. CONCLUSIONS Heel lift use resulted in decreased patellofemoral joint stress and impulse without associated changes in step length or frequency, or other variables shown to influence patellofemoral joint stress. The center of pressure at initial contact was also more anterior using heel lifts. The use of heel lifts may have therapeutic benefits for runners with patellofemoral pain if the primary goal is to reduce patellofemoral joint stress. LEVEL OF EVIDENCE 3b.
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Affiliation(s)
- Zachary Mestelle
- La Crosse Institute for Movement Science, Department of Health Professions - Physical Therapy Program, University of Wisconsin-La Crosse, La Crosse, WI, USA
| | - Thomas Kernozek
- La Crosse Institute for Movement Science, Department of Health Professions - Physical Therapy Program, University of Wisconsin-La Crosse, La Crosse, WI, USA
| | - Kelly S Adkins
- La Crosse Institute for Movement Science, Department of Health Professions - Physical Therapy Program, University of Wisconsin-La Crosse, La Crosse, WI, USA
| | - Jessica Miller
- La Crosse Institute for Movement Science, Department of Health Professions - Physical Therapy Program, University of Wisconsin-La Crosse, La Crosse, WI, USA
| | - Naghmeh Gheidi
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI, USA
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Koli J, Multanen J, Kujala UM, Häkkinen A, Nieminen MT, Kautiainen H, Lammentausta E, Jämsä T, Ahola R, Selänne H, Kiviranta I, Heinonen A. Effects of Exercise on Patellar Cartilage in Women with Mild Knee Osteoarthritis. Med Sci Sports Exerc 2016; 47:1767-74. [PMID: 25668399 DOI: 10.1249/mss.0000000000000629] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE This study aims to investigate the effects of exercise on patellar cartilage using T2 relaxation time mapping of magnetic resonance imaging in postmenopausal women with mild patellofemoral joint osteoarthritis (OA). METHODS Eighty postmenopausal women (mean age, 58 (SD, 4.2) yr) with mild knee OA were randomized to either a supervised progressive impact exercise program three times a week for 12 months (n = 40) or a nonintervention control group (n = 40). Biochemical properties of cartilage were estimated using T2 relaxation time mapping, a parameter sensitive to collagen integrity, collagen orientation, and tissue hydration. Leg muscle strength and power, aerobic capacity, and self-rated assessment with the Knee Injury and Osteoarthritis Outcome Score were also measured. RESULTS After intervention, full-thickness patellar cartilage T2 values had medium-size effect (d = 0.59; 95% confidence interval, 0.16 to 0.97; P = 0.018); the change difference was 7% greater in the exercise group compared with the control group. In the deep half of tissue, the significant exercise effect size was medium (d = 0.56; 95% confidence interval, 0.13 to 0.99; P = 0.013); the change difference was 8% greater in the exercise group compared with controls. Furthermore, significant medium-size T2 effects were found in the total lateral segment, lateral deep, and lateral superficial zones in favor of the exercise group. Extension force was 11% greater (d = 0.63, P = 0.006) and maximal aerobic capacity was 4% greater (d = 0.55, P = 0.028) in the exercise group than in controls. No changes in Knee Injury and Osteoarthritis Outcome Score emerged between the groups. CONCLUSIONS Progressively implemented high-impact and intensive exercise creates enough stimuli and exerts favorable effects on patellar cartilage quality and physical function in postmenopausal women with mild knee OA.
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Affiliation(s)
- Jarmo Koli
- 1Department of Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND; 2Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, FINLAND; 3Department of Diagnostic Radiology, Oulu University Hospital, Oulu, FINLAND; 4Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, FINLAND; 5Department of Radiology, University of Oulu, Oulu, FINLAND; 6Department of General Practice and Primary Healthcare, University of Helsinki, Helsinki, FINLAND; 7Unit of Primary Healthcare, Kuopio University Hospital, Kuopio, FINLAND; 8Department of Medical Technology, Institute of Biomedicine, University of Oulu, Oulu, Finland; 9LIKES Research Center, Jyväskylä, FINLAND; and 10Department of Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, FINLAND
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Sterzing T, Frommhold C, Rosenbaum D. In-shoe plantar pressure distribution and lower extremity muscle activity patterns of backward compared to forward running on a treadmill. Gait Posture 2016; 46:135-41. [PMID: 27131191 DOI: 10.1016/j.gaitpost.2016.03.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 03/03/2016] [Accepted: 03/09/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Backward locomotion in humans occurs during leisure, rehabilitation, and competitive sports. Little is known about its general biomechanical characteristics and how it affects lower extremity loading as well as muscle coordination. Thus, the purpose of this research was to analyze in-shoe plantar pressure patterns and lower extremity muscle activity patterns for backward compared to forward running. METHODS On a treadmill, nineteen runners performed forward running at their individually preferred speed, followed by backward running at 70% of their self-selected forward speed. In-shoe plantar pressures of nine foot regions and muscular activity of nine lower extremity muscles were recorded simultaneously over a one-minute interval. Backward and forward running variables were averaged over the accumulated steps and compared with Wilcoxon-signed rank tests (p<.05). RESULTS For backward compared to forward running, in-shoe plantar pressure distribution showed a load increase under metatarsal heads I and II, as well as under the medial midfoot. This was indicated by higher maximum forces and peak pressures, and by longer contact times. Muscle activity showed significantly higher mean amplitudes during backward running in the semitendinosus, rectus femoris, vastus lateralis, and gluteus medius during stance, and in the rectus femoris during swing phase, while significantly lower mean amplitudes were observed in the tibialis anterior during swing phase. CONCLUSION Observations indicate plantar foot loading and muscle activity characteristics that are specific for the running direction. Thus, backward running may be used on purpose for certain rehabilitation tasks, aiming to strengthen respective lower extremity muscles. Furthermore, the findings are relevant for sport specific backward locomotion training. Finally, results provide an initial baseline for innovative athletic footwear development aiming to increase comfort and performance during backward running.
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Affiliation(s)
- Thorsten Sterzing
- Li Ning Sports Science Research Centre, Beijing, China; Department of Human Locomotion, Chemnitz University of Technology, Chemnitz, Germany
| | - Clivia Frommhold
- Department Medical Affairs, Bauerfeind AG, Zeulenroda, Germany; Department of Human Locomotion, Chemnitz University of Technology, Chemnitz, Germany
| | - Dieter Rosenbaum
- Movement Analysis Lab, Institute for Experimental Musculoskeletal Medicine, University Hospital Münster, Münster, Germany.
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VANNATTA CHARLESNATHAN, KERNOZEK THOMASW. Patellofemoral Joint Stress during Running with Alterations in Foot Strike Pattern. Med Sci Sports Exerc 2015; 47:1001-8. [DOI: 10.1249/mss.0000000000000503] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Lower limb control and strength in runners with and without patellofemoral pain syndrome. Gait Posture 2015; 41:813-9. [PMID: 25800001 DOI: 10.1016/j.gaitpost.2015.02.020] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 09/10/2014] [Accepted: 02/28/2015] [Indexed: 02/02/2023]
Abstract
Recreational runners with patellofemoral pain syndrome (PFPS) have been shown to present altered movement kinematics, muscle activations, and ground reaction forces (GRF) during running as well as decreased lower limb strength. However, these variables have never been concurrently evaluated in a specific cohort. Therefore, the aim of this study was to compare lower limb control variables during running in recreational runners with and without PFPS. Lower limb control during treadmill running under typical training conditions (usual shoes, foot strike pattern, and speed) was compared between runners with (n=21) and without (n=20) PFPS using lower limb kinematics, electromyographic (EMG) recordings from representative muscles (gluteus medius/maximus, quadriceps and soleus), and vertical GRF. Isometric muscle strength was also evaluated. When comparing all runners from both groups, no between-group differences were found in variables commonly associated with PFPS such as peak hip adduction, hip internal rotation, contralateral pelvic drop, EMG of gluteal and quadriceps muscles, vertical loading rate, or lower limb strength. However, runners with PFPS showed significantly higher hip adduction at toe-off, lower excursion in hip adduction during late-stance, and longer duration of soleus activation. Sub-analyses were performed for females and for rearfoot strikers (RFS), and revealed that these subgroups accounted for most of between-group differences in hip adduction kinematics. Specifically for RFS with PFPS, lower activation of gluteus medius as well as lower GRF were observed. Our results suggest that deficits reported in runners with PFPS may vary depending on gender and on foot strike pattern.
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Kachanathu SJ, Alenazi AM, Algarni AD, Hafez AR, Hameed UA, Nuhmani S, Melam G. Effect of forward and backward locomotion training on anaerobic performance and anthropometrical composition. J Phys Ther Sci 2014; 26:1879-82. [PMID: 25540487 PMCID: PMC4273047 DOI: 10.1589/jpts.26.1879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 06/05/2014] [Indexed: 11/26/2022] Open
Abstract
[Purpose] Forward walking (FW) and backward walking (BW) on a treadmill is a common tool
for lower extremity rehabilitation in the clinical setting. The purpose of this study was
to evaluate the effects on anaerobic performance and anthropometrical adaptations during
FW and BW on a treadmill. [Subjects and Methods] A convenience sample of thirty healthy
male subjects with a mean age of 20.93 ± 2.54 years participated in this study. Subjects
were divided into 2 groups, a Forward Walking Group (FWG) (n=15) and a Backward Walking
Group (BWG) (n=15), which performed FW and BW on a treadmill at 10° inclination,
respectively. The training consisted of three sessions per week for 6 weeks. Study
outcomes such as anaerobic performance and anthropometrical body composition were measured
at pre- and post-intervention. [Results] Both FW and BW improved anaerobic performance
significantly, and the BW group showed better performance than FW. However, changes in
anthropometrical body composition were found to be not significant after six weeks of
intervention in both the FW and BW groups. [Conclusions] BW training in rehabilitation can
be considered more effective than FW at improving anaerobic performance. We also conclude
that six weeks of FW and BW training is insufficient for eliciting changes in the body
composition.
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Affiliation(s)
- Shaji John Kachanathu
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Kingdom of Saudi Arabia
| | | | | | | | | | | | - Ganeshwerarao Melam
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Kingdom of Saudi Arabia
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Lenhart RL, Thelen DG, Wille CM, Chumanov ES, Heiderscheit BC. Increasing running step rate reduces patellofemoral joint forces. Med Sci Sports Exerc 2014; 46:557-64. [PMID: 23917470 DOI: 10.1249/mss.0b013e3182a78c3a] [Citation(s) in RCA: 158] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Increasing step rate has been shown to elicit changes in joint kinematics and kinetics during running, and it has been suggested as a possible rehabilitation strategy for runners with patellofemoral pain. The purpose of this study was to determine how altering step rate affects internal muscle forces and patellofemoral joint loads, and then to determine what kinematic and kinetic factors best predict changes in joint loading. METHODS We recorded whole body kinematics of 30 healthy adults running on an instrumented treadmill at three step rate conditions (90%, 100%, and 110% of preferred step rate). We then used a 3-D lower extremity musculoskeletal model to estimate muscle, patellar tendon, and patellofemoral joint forces throughout the running gait cycles. In addition, linear regression analysis allowed us to ascertain the relative influence of limb posture and external loads on patellofemoral joint force. RESULTS Increasing step rate to 110% of the preferred reduced peak patellofemoral joint force by 14%. Peak muscle forces were also altered as a result of the increased step rate with hip, knee, and ankle extensor forces, and hip abductor forces all reduced in midstance. Compared with the 90% step rate condition, there was a concomitant increase in peak rectus femoris and hamstring loads during early and late swing, respectively, at higher step rates. Peak stance phase knee flexion decreased with increasing step rate and was found to be the most important predictor of the reduction in patellofemoral joint loading. CONCLUSION Increasing step rate is an effective strategy to reduce patellofemoral joint forces and could be effective in modulating biomechanical factors that can contribute to patellofemoral pain.
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Affiliation(s)
- Rachel L Lenhart
- 1Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI; 2Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI; and 3Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI
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Howe A, Campbell A, Ng L, Hall T, Hopper D. Effects of two different knee tape procedures on lower-limb kinematics and kinetics in recreational runners. Scand J Med Sci Sports 2014; 25:517-24. [PMID: 24989992 DOI: 10.1111/sms.12269] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2014] [Indexed: 11/27/2022]
Affiliation(s)
- A. Howe
- School of Physiotherapy and Exercise Science, Curtin Health Innovation Research Institute; Curtin University; Perth Australia
| | - A. Campbell
- School of Physiotherapy and Exercise Science, Curtin Health Innovation Research Institute; Curtin University; Perth Australia
| | - L. Ng
- School of Physiotherapy and Exercise Science, Curtin Health Innovation Research Institute; Curtin University; Perth Australia
| | - T. Hall
- School of Physiotherapy and Exercise Science, Curtin Health Innovation Research Institute; Curtin University; Perth Australia
| | - D. Hopper
- School of Physiotherapy and Exercise Science, Curtin Health Innovation Research Institute; Curtin University; Perth Australia
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