1
|
Cabral HV, Devecchi V, Oxendale C, Jenkinson N, Falla D, Gallina A. Effect of movement-evoked and tonic experimental pain on muscle force production. Scand J Med Sci Sports 2024; 34:e14509. [PMID: 37803936 PMCID: PMC10952217 DOI: 10.1111/sms.14509] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/14/2023] [Accepted: 09/19/2023] [Indexed: 10/08/2023]
Abstract
INTRODUCTION When performing an exercise or a functional test, pain that is evoked by movement or muscle contraction could be a stronger stimulus for changing how individuals move compared to tonic pain. We investigated whether the decrease in muscle force production is larger when experimentally-induced knee pain is directly associated to the torque produced (movement-evoked) compared to a constant painful stimulation (tonic). METHODS Twenty-one participants performed three isometric knee extension maximal voluntary contractions without pain (baseline), during pain, and after pain. Knee pain was induced using sinusoidal electrical stimuli at 10 Hz over the infrapatellar fat pad, applied continuously or modulated proportionally to the knee extension torque. Peak torque and contraction duration were averaged across repetitions and normalized to baseline. RESULTS During tonic pain, participants reported lower pain intensity during the contraction than at rest (p < 0.001), whereas pain intensity increased with contraction during movement-evoked pain (p < 0.001). Knee extension torque decreased during both pain conditions (p < 0.001), but a larger reduction was observed during movement-evoked compared to tonic pain (p < 0.001). Participants produced torque for longer during tonic compared to movement-evoked pain (p = 0.005). CONCLUSION Our results indicate that movement-evoked pain was a more potent stimulus to reduce knee extension torque than tonic pain. The longer contraction time observed during tonic pain may be a result of a lower perceived pain intensity during muscle contraction. Overall, our results suggest different motor adaptation to tonic and movement-evoked pain and support the notion that motor adaptation to pain is a purposeful strategy to limit pain. This mechanistic evidence suggests that individuals experiencing prevalently tonic or movement-evoked pain may exhibit different motor adaptations, which may be important for exercise prescription.
Collapse
Affiliation(s)
- Hélio V. Cabral
- School of Sport, Exercise and Rehabilitation SciencesCollege of Life and Environmental Sciences, University of BirminghamBirminghamUK
- Centre of Precision Rehabilitation for Spinal PainCollege of Life and Environmental Sciences, University of BirminghamBirminghamUK
- Department of Clinical and Experimental SciencesUniversità degli Studi di BresciaBresciaItaly
| | - Valter Devecchi
- School of Sport, Exercise and Rehabilitation SciencesCollege of Life and Environmental Sciences, University of BirminghamBirminghamUK
- Centre of Precision Rehabilitation for Spinal PainCollege of Life and Environmental Sciences, University of BirminghamBirminghamUK
| | - Chelsea Oxendale
- School of Sport, Exercise and Rehabilitation SciencesCollege of Life and Environmental Sciences, University of BirminghamBirminghamUK
- Centre of Precision Rehabilitation for Spinal PainCollege of Life and Environmental Sciences, University of BirminghamBirminghamUK
- Department of Sport and Exercise SciencesUniversity of ChesterChesterUK
| | - Ned Jenkinson
- School of Sport, Exercise and Rehabilitation SciencesCollege of Life and Environmental Sciences, University of BirminghamBirminghamUK
- Centre for Human Brain Health, College of Life and Environmental SciencesUniversity of BirminghamBirminghamUK
| | - Deborah Falla
- School of Sport, Exercise and Rehabilitation SciencesCollege of Life and Environmental Sciences, University of BirminghamBirminghamUK
- Centre of Precision Rehabilitation for Spinal PainCollege of Life and Environmental Sciences, University of BirminghamBirminghamUK
| | - Alessio Gallina
- School of Sport, Exercise and Rehabilitation SciencesCollege of Life and Environmental Sciences, University of BirminghamBirminghamUK
- Centre of Precision Rehabilitation for Spinal PainCollege of Life and Environmental Sciences, University of BirminghamBirminghamUK
| |
Collapse
|
2
|
Bolgla LA, Gibson HN, Hannah DC, Curry-McCoy T. Comparison of the Frontal Plane Projection Angle and the Dynamic Valgus Index to Identify Movement Dysfunction in Females with Patellofemoral Pain. Int J Sports Phys Ther 2023; V18:619-625. [PMID: 37425107 PMCID: PMC10324282 DOI: 10.26603/001c.74269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/08/2023] [Indexed: 07/11/2023] Open
Abstract
Background Clinicians typically measure the knee frontal plane projection angle (FPPA) during a single-leg squat to identify females with patellofemoral pain (PFP). A limitation of this measure is minimal attention to movement of the pelvis on the femur that can create knee valgus loading. The dynamic valgus index (DVI) may be a better assessment. Hypothesis/Purpose The purpose of this study was to compare the knee FPPA and DVI between females with and without PFP and determine if the DVI better identified females with PFP than the knee FPPA. Study Design Case-control. Methods Sixteen females with and 16 without PFP underwent 2-dimensional motion analysis when performing five trials of a single-leg squat. The average peak knee FPPA and peak DVI were analyzed. Independent t-tests determined between-group peak knee FPPA and peak DVI differences. Receiver operating characteristic (ROC) curves determined the area under the curve (AUC) scores for sensitivity and 1 - specificity of each measure. Paired-sample area difference under the ROC curves was conducted to determine differences in the AUC for the knee FPPA and DVI. Positive likelihood ratios were calculated for each measure. The significance level was p < 0.05. Results Females with PFP exhibited a higher knee FPPA (p = 0.001) and DVI (p = 0.015) than controls. AUC scores were .85 (p = 0.001) and .76 (p = 0.012) for the knee FPPA and DVI, respectively. Paired-sample area difference under the ROC curves showed a similar (p = 0.10) AUC for the knee FPPA and DVI. The knee FPPA had 87.5% sensitivity and 68.8% specificity; the DVI had 81.3% sensitivity and 81.0% specificity. Positive likelihood ratios for the knee FPPA and DVI were 2.8 and 4.3, respectively. Conclusion The DVI during a single-leg squat may be another useful tool for discriminating between females with and without PFP. Level of Evidence 3a.
Collapse
|
3
|
Glaviano NR, Simon MM, Bazett-Jones DM. Pain Variability and Subjective Function in Individuals With Patellofemoral Pain: A Short Report. J Athl Train 2022; 57:165-169. [PMID: 34329459 PMCID: PMC8876885 DOI: 10.4085/1062-6050-0261.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Individuals with patellofemoral pain (PFP) experience discomfort during various functional activities. Long-term pain is a common consequence of PFP, yet little is known about daily pain variability. Our study consisted of 25 individuals with PFP who completed the Anterior Knee Pain Scale (AKPS) and recorded their daily pain over 10 days. Pain was evaluated using 2 measures of intensity (baseline pain, 10-day average pain) and 2 measures of variability (mean square of successive differences, probability of acute change). Associations between AKPS and the 4 pain measures were calculated with Pearson correlations. We calculated a linear regression to examine the amount of variance in the AKPS explained by the 4 pain measures. Greater mean square of successive differences values were moderately associated with lesser AKPS scores (r = -0.648, P < .001). Mean square of successive differences and 10-day averaged pain were the strongest predictors of AKPS (R2 = 0.565, P < .001). Pain variability provided a unique perspective on the pain experience and predicted patient-oriented function in individuals with PFP.
Collapse
Affiliation(s)
| | - Mikayla M. Simon
- School of Exercise and Rehabilitation Sciences, University of Toledo, OH
| | | |
Collapse
|
4
|
Pain Severity during Functional Activities in Individuals with Patellofemoral Pain: A Systematic Review with Meta-Analysis. J Sci Med Sport 2022; 25:399-406. [DOI: 10.1016/j.jsams.2022.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 01/18/2022] [Accepted: 01/23/2022] [Indexed: 11/23/2022]
|
5
|
Feasibility of Superimposed Neuromuscular Electrical Stimulation to the Gluteus Medius During a Resistance Training Program. J Sport Rehabil 2021; 31:279-285. [PMID: 34894628 DOI: 10.1123/jsr.2021-0095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 08/12/2021] [Accepted: 09/13/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Gluteus medius (GMed) weakness is a common impairment seen across multiple lower-extremity pathologies. Greater GMed weakness is moderately associated with greater frontal plane motion, often termed dynamic knee valgus during functional tasks which may increase risk of lower-extremity injury. Neuromuscular electrical stimulation (NMES) superimposed to targeted muscles has emerged in clinical practice; however, NMES superimposed to the GMed in unknown. It is essential to assess the safety, credibility, and expectancy of NMES superimposed to the GMed prior to implementation in clinical practice. The objective of this study was to evaluate feasibility, safety, credibility, and expectancy of improvement with a 2-week intervention with or without NMES to the GMed in females with dynamic knee valgus. DESIGN Feasibility study. METHODS A total of 22 adult females with dynamic knee valgus (age = 21.8 [1.4] y, mass = 76.9 [18.8] kg, height = 1.7 [0.1] m) completed a 2-week intervention with NMES or a sham treatment superimposed to the GMed during all therapeutic exercises. Feasibility was assessed by recruitment and completion rate, while safety was assessed by the total number of adverse events. Treatment credibility and expectancy was assessed with the Credibility Expectancy Questionnaire. Mixed-measure analysis of variance were used for statistical analysis (P ≤ .05). RESULTS Recruitment was completed in 5 months with 100% completion rate and no adverse events. There was no difference in treatment credibility between groups (NMES = 23.7 [2.3], sham = 21.7 [3.4], P = .12); however, the NMES group demonstrated a greater expectancy score (NMES = 20.0 [3.8], sham = 15.9 [5.1], P = .045). CONCLUSION Resistance training with NMES superimposed to the GMed is a feasible and safe intervention that resulted in greater expectance of success. Clinicians may consider superimposing NMES to the gluteal muscles when addressing muscle weakness in individuals with dynamic knee valgus.
Collapse
|
6
|
Hu G, Wang W, Chen B, Zhi H, Yudi Li, Shen Y, Wang K. Concurrent validity of evaluating knee kinematics using Kinect system during rehabilitation exercise. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2021. [DOI: 10.1016/j.medntd.2021.100068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
|
7
|
Arhos EK, Lang CE, Steger-May K, Van Dillen LR, Yemm B, Salsich GB. Task-specific movement training improves kinematics and pain during the Y-balance test and hip muscle strength in females with patellofemoral pain. J ISAKOS 2021; 6:277-282. [PMID: 34001505 DOI: 10.1136/jisakos-2020-000551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Task-specific movement training is a proposed intervention for patellofemoral pain aimed to optimise movement during daily tasks. Focused, progressive task practice emphasising optimal limb alignment may yield improvements in performance-based function and hip muscle strength, and transfer learnt movement patterns to untrained tasks. The purpose of this study was to determine if task-specific movement training improves performance-based function (composite score, movement, pain during movement) in an untrained task. Our secondary purpose was to test whether hip muscle strength improved following the movement training intervention. METHODS This study was a secondary analysis of a prospective, non-randomised, within-group, double-baseline study. Twenty-three females with patellofemoral pain underwent task-specific movement training two times/week for 6 weeks. Outcomes were collected at three time points: enrolment (baseline), 6 weeks (preintervention) and 12 weeks (postintervention). A repeated measures analysis of variance tested whether the change during the intervention phase was greater than the change during the control phase. Y-balance composite score, hip and knee kinematics and pain during the Y-balance test were primary outcome measures; strength of the hip lateral rotator, abductor and extensor muscles was a secondary outcome measure. RESULTS The change in composite score for the Y-balance test was not statistically significantly different between the intervention and control phases (p=0.16). The change during the intervention phase exceeded the change during the control phase for hip and knee kinematics and pain during the Y-balance test, with all variables improving (p<0.0001). The change during the intervention phase was greater than the control phase for hip muscle strength, with all variables improving (p<0.04). CONCLUSION Although the Y-balance test composite score did not improve, performance-based function during an untrained task, measured by movement and pain during the test, improved following task-specific movement training. Hip muscle strength improved, despite no focused muscle strengthening. LEVEL OF EVIDENCE Level II.
Collapse
Affiliation(s)
- Elanna K Arhos
- Biomechanics and Movement Science, University of Delaware, Newark, Delaware, USA
| | - Catherine E Lang
- Program in Physical Therapy, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Karen Steger-May
- Division of Biostatistics, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Linda R Van Dillen
- Program in Physical Therapy, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Barbara Yemm
- Program in Physical Therapy, Saint Louis University, St Louis, Missouri, USA
| | - Gretchen B Salsich
- Program in Physical Therapy, Saint Louis University, St Louis, Missouri, USA
| |
Collapse
|
8
|
Aghakeshizadeh F, Letafatkar A, Thomas AC. Internal and external focus show similar effect on the gait kinematics in patients with patellofemoral pain: A randomised controlled trial. Gait Posture 2021; 84:155-161. [PMID: 33340845 DOI: 10.1016/j.gaitpost.2020.11.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/02/2020] [Accepted: 11/30/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this study was to examine how attentional focus during training influences the effects of a 6-week hip-knee strength training program on pain, function, strength, and kinematics in males and females with Patellofemoral pain (PFP). METHODS Seventy-five males and females with PFP were randomly allocated to a group that trained with an internal focus (n = 25), a group that trained with an external focus (n = 25), or a control group (n = 25). All patients completed testing before (baseline) and after (posttest) the 6-week period. The primary outcome was pain, assessed by Visual Analog Scale (VAS). The secondary outcomes were function, hip muscles strength and lower extremity kinematics, assessed by Kujala Questionnaire, handheld dynamometer and a 2-D motion capture, respectively. All outcomes were measured at the baseline and after the 6-week intervention. Analysis of covariance was used to compare posttest outcomes among the groups while accounting for group differences in baseline performance. RESULTS The hip-knee strengthening exercises resulted in improved knee valgus (ES(95 % CI) = 0.43(0.26 to 0.75), p = 0.03), and external rotator strength (ES(95 % CI) = 0.51(0.12 to 0.78), p = 0.03) for males and females who trained with an external compared to internal focus. CONCLUSIONS Our findings indicate that males and females with PFP may benefit from completing a hip-knee strengthening training program with an external focus vs. an internal focus. Physical therapists and clinicians should consider using instructions that promote an external focus when implementing hip-knee strengthening training programs with PFP patients. This result could be strengthened or re-enforced by larger studies with longer follow up.
Collapse
Affiliation(s)
| | - Amir Letafatkar
- Sports Injury and Corrective Exercises, Kharazmi University, Tehran, Iran.
| | - Abbey C Thomas
- Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, United States.
| |
Collapse
|
9
|
Sahrmann S. Defining Our Diagnostic Labels Will Help Define Our Movement Expertise and Guide Our Next 100 Years. Phys Ther 2021; 101:5943786. [PMID: 33126249 DOI: 10.1093/ptj/pzaa196] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 08/02/2020] [Indexed: 02/09/2023]
Affiliation(s)
- Shirley Sahrmann
- S. Sahrmann, PT, PhD, FAPTA, Program in Physical Therapy, Washington University School of Medicine Box 8502 4444 Forest Park Blvd., Saint Louis, MO 63108-2212, USA
| |
Collapse
|
10
|
CONSISTENCY OF DYNAMIC KNEE VALGUS KINEMATICS AND PAIN ACROSS FUNCTIONAL TASKS IN FEMALES WITH PATELLOFEMORAL PAIN: A CROSS-SECTIONAL STUDY. Int J Sports Phys Ther 2020; 15:985-994. [PMID: 33344015 DOI: 10.26603/ijspt20200985] [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: 11/18/2022] Open
Abstract
Background and Purpose Dynamic knee valgus has been associated with patellofemoral pain (PFP) during high-level tasks, however, repeated lower-level stresses may be an alternative pain mechanism. The primary purpose of the current study was to examine the consistency of dynamic knee valgus and task-elicited pain demonstrated by females with PFP across four common functional tasks (stair ascent, stair descent, sit-to-stand, and stand-to-sit). A secondary purpose was to assess the correlation between the clinical test of single-limb squat and functional tasks. Hypothesis Females with patellofemoral pain will demonstrate a positive relationship in magnitude of dynamic knee valgus and task-elicited pain across functional tasks. Individuals who demonstrated greater dynamic knee valgus and task-elicited pain during the clinical test of single-limb squat would demonstrate greater dynamic knee valgus and task elicited pain during stair ascent/descent and sit-to-stand/stand-to-sit tasks. Study Design Cross-sectional study; secondary analysis of a feasibility intervention study. Methods Twenty-three women with patellofemoral pain (age: 21.8 SD 3.7 years; BMI: 22.2 SD 2.0 kg/m2) participated. Three-dimensional kinematic data were captured during task completion. Hip and knee frontal and transverse plane angles at 45 ° of knee flexion, and pain using a visual analog scale, were assessed during single-limb squat, stair ascent/descent, and sit-to-stand. Pearson product-moment correlation coefficients were calculated to examine between-task relationships for each variable at the pre-intervention assessment. Results Correlation coefficients between tasks ranged from 0.23-0.76 for hip frontal plane measures (7/10 significant relationships, p<0.02), 0.31-0.90 for hip transverse plane measures (7/10 significant, p<0.01), 0.87-0.95 for knee frontal plane measures (10/10 significant, p<0.01), and 0.54-0.86 for knee transverse plane measures (10/10 significant, p<0.01). Correlations spanned 0.59-0.85 for pain during tasks (10/10 significant, p<0.01). Conclusion Females with patellofemoral pain demonstrated positive correlations in dynamic knee valgus kinematics and task-elicited pain across five tasks. Movement and pain during the clinical test of single-limb squat test also was correlated with movement and pain during the functional tasks of stair ascent/descent and sit-to-stand. Level of Evidence Level 2b.
Collapse
|
11
|
Davis IS, Tenforde AS, Neal BS, Roper JL, Willy RW. Gait Retraining as an Intervention for Patellofemoral Pain. Curr Rev Musculoskelet Med 2020; 13:103-114. [PMID: 32170556 DOI: 10.1007/s12178-020-09605-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Movement retraining in rehabilitation is the process by which a motor program is changed with the overall goal of reducing pain or injury risk. Movement retraining is an important component of interventions to address patellofemoral pain. The purpose of this paper is to review the methods and results of current retraining studies that are aimed at reducing symptoms of patellofemoral pain. RECENT FINDINGS The majority of studies reviewed demonstrated some improvement in patellofemoral pain symptoms and overall function. However, the degree of improvement as well as the persistence of improvement over time varied between studies. The greatest pain reduction and persistent changes were noted in those studies that incorporated a faded feedback design including between 8 and 18 sessions over 2-6 weeks, typically 3-4 sessions per week. Additionally, dosage in these studies increased to 30-45 min during later sessions, resulting in 177-196 total minutes of retraining. In contrast, pain reductions and persistence of changes were the least in studies where overall retraining volume was low and feedback was either absent or continual. Faulty movement patterns have been associated with patellofemoral pain. Studies have shown that strengthening alone does not alter these patterns, and that addressing the motor program is needed to effect these changes. Based upon the studies reviewed here, retraining faulty patterns, when present, appears to play a significant role in addressing patellofemoral pain. Therefore, movement retraining, while adhering to basic motor control principles, should be part of a therapist's intervention skillset when treating patients with PFP.
Collapse
Affiliation(s)
- Irene S Davis
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.
- Spaulding National Running Center, 1575 Cambridge St, Cambridge, MA, 02138, USA.
| | - Adam S Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Spaulding National Running Center, 1575 Cambridge St, Cambridge, MA, 02138, USA
| | - Bradley S Neal
- Sports & Exercise Medicine, Queen Mary University of London, London, UK
| | - Jenevieve L Roper
- Department of Health and Human Sciences, Loyola Marymount University, Los Angeles, CA, USA
| | - Richard W Willy
- School of Physical Therapy & Health Sciences, University of Montana, Missoula, MT, USA
| |
Collapse
|
12
|
Di Staulo AM, Scholtes SA, Salsich GB. A descriptive report of the variability in 3D hip and knee kinematics during a single limb squat in women who have patellofemoral pain and visually classified dynamic knee valgus. Physiother Theory Pract 2019; 37:1481-1490. [PMID: 31809631 DOI: 10.1080/09593985.2019.1698082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: To describe the variability in: (1) the contributions of 3D hip and knee kinematics to the dynamic knee valgus (DKV) movement pattern during a single limb squat in women with patellofemoral pain; and (2) the 3D strategies used to reduce DKV following an intervention.Methods: Secondary analysis of a feasibility study investigating a movement training intervention. In 23 participants, 2D knee frontal plane projection angles (FPPA) and 3D hip and knee frontal and transverse plane angles at peak knee flexion were calculated during a single limb squat at pre- and post-intervention, and the change in 2D and 3D angles computed. 3D angles at pre-intervention were summed for each participant to create cumulative bar graphs. Similar graphs were created for change in 3D angles. For visual comparison, graphs were ordered by increasing knee FPPA or change in knee FPPA.Results: The knee FPPA decreased from a mean of 7.2 degrees (SD: 7.1) to a mean of -8.9 degrees (SD: 8.9) following the intervention. A large portion of DKV, and change in DKV, was due to hip adduction and knee lateral rotation, yet participants with similar knee FPPA and change in knee FPPA displayed variation in all 3D components and change in 3D components.Conclusion: People who demonstrate similar observed movement patterns during a weight-bearing task may use different 3D strategies for execution.
Collapse
Affiliation(s)
- Anna M Di Staulo
- Program in Physical Therapy, Saint Louis University, St. Louis, MO, USA
| | - Sara A Scholtes
- Program in Physical Therapy, Saint Louis University, St. Louis, MO, USA
| | | |
Collapse
|
13
|
Vasiljevic D, Salsich GB, Snozek D, Aubin B, Foster SN, Mueller MJ, Clohisy JC, Harris-Hayes M. Three dimensional kinematics of visually classified lower extremity movement patterns during a single leg squat among people with chronic hip joint pain. Physiother Theory Pract 2018; 36:598-606. [PMID: 29963931 DOI: 10.1080/09593985.2018.1491081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Describe the proportional occurrence of visually determined, lower extremity movement patterns (dynamic knee valgus [DKVal], neutral [NEU], dynamic knee varus [DKVar]) during a single leg squat (SLSquat) among patients with chronic hip joint pain (CHJP). Compare 3D hip and pelvic kinematics among the categories and determine whether within-session movement pattern changes are possible among those who demonstrate DKVal or DKVar. Design: Cross-sectional. Setting: Movement science laboratory. Participants: 36 patients with CHJP (18 to 40 years). Main Outcome Measures: Visually based classification of lower extremity movement and 3D kinematic angles of hip and pelvis during SLSquat, performed under usual (self-selected) and modified (therapist instruction) conditions. Results: Based on visual appraisal, 14 patients demonstrated DKVal, 22 demonstrated NEU and none demonstrated DKVar. Those with DKVal demonstrated greater hip adduction (23.5 + 5.7º vs. 16.0 + 5.7º, p < 0.001) and internal rotation (7.4 + 7.1º vs. 1.6 + 7.0º, p = 0.023) than those with NEU. Compared to the usual condition, the DKVal group demonstrated significant decrease in hip adduction (23.5 + 5.7° vs. 20.9 + 5.8°, p = 0.001) and internal rotation (7.4 + 7.1° vs. 5.3 + 7.8°, p = .050) in the modified condition. Conclusions: Patients with CHJP demonstrated 2 movement patterns, DKVal and NEU. Compared to NEU, those with DKVal demonstrated greater hip adduction and internal rotation motion and were able to make small modifications to their movement pattern with therapist instruction.
Collapse
Affiliation(s)
- Davor Vasiljevic
- Program in Physical Therapy, Washington University School of Medicine , St. Louis, USA
| | | | - Darrah Snozek
- Program in Physical Therapy, Washington University School of Medicine , St. Louis, USA
| | - Bradley Aubin
- Program in Physical Therapy, Washington University School of Medicine , St. Louis, USA
| | - Stefanie N Foster
- Program in Physical Therapy, Washington University School of Medicine , St. Louis, USA
| | - Michael J Mueller
- Program in Physical Therapy, Washington University School of Medicine , St. Louis, USA.,Department of Radiology, Washington University School of Medicine , St. Louis, USA
| | - John C Clohisy
- Department of Orthopaedic Surgery, Washington University School of Medicine , St Louis, USA
| | - Marcie Harris-Hayes
- Program in Physical Therapy, Washington University School of Medicine , St. Louis, USA.,Department of Orthopaedic Surgery, Washington University School of Medicine , St Louis, USA
| |
Collapse
|