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Carvalho C, Viadanna Serrão F, Felipe Martinez A, Da Silva Serrão PRM. Three-dimensional kinematics of the trunk, pelvis, hip, and knee during the single-leg squat and hip torque in subjects with isolated patellofemoral osteoarthritis compared to individually matched controls: Preliminary results. Arch Rheumatol 2024; 39:33-45. [PMID: 38774690 PMCID: PMC11104754 DOI: 10.46497/archrheumatol.2024.9814] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 03/22/2023] [Indexed: 05/24/2024] Open
Abstract
Objectives: This study aimed to compare three-dimensional kinematic of the trunk, pelvis, hip, and knee during the single-leg squat and hip torque in individuals with and without isolated patellofemoral osteoarthritis (PFOA). Patients and methods: This cross-sectional study evaluated trunk, pelvis, hip, and knee kinematics at 30°, 45°, and 60° knee flexion during the single-leg squat using the Vicon motion capture and analysis system, the Nexus System 2.1.1, and 3D Motion Monitor software. Sixteen individuals (8 males, 8 females; mean age: 49.3±6.2 years; range 40 to 61 years) participated in the study, of which eight were PFOA patients and eight were healthy controls. Isometric hip abductor, extensor, and external rotator torques were evaluated using a handheld dynamometer. Results: The PFOA group exhibited greater hip adduction at 30° (p=0.008), 45° (p=0.005), and 60° (p=0.008) knee flexion in the descending phase of the single-leg squat, as well as at 60° (p=0.009) and 45° (p=0.03) knee flexion in the ascending phase. No significant differences were found between groups for other kinematic variables (p>0.05). The PFOA group exhibited lower isometric hip abductor (p=0.02), extensor (p <0.001), and external rotator (p=0.007) torques. Conclusion: Individuals with PFOA exhibited excessive hip adduction that could increase stress on the lateral patellofemoral joint at 30°, 45°, and 60° knee flexion during the single-leg squat and exhibited weakness of the hip abductors, extensors, and external rotators in comparison to healthy controls.
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Affiliation(s)
- Cristiano Carvalho
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Fábio Viadanna Serrão
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
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Association of Proximal and Distal Factors With Lower Limb Kinematics During a Classical Ballet Jump. J Sport Rehabil 2023; 32:170-176. [PMID: 36049748 DOI: 10.1123/jsr.2021-0256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 07/08/2022] [Accepted: 07/18/2022] [Indexed: 02/07/2023]
Abstract
CONTEXT Excessive dynamic lower limb misalignment may predispose ballet dancers to jump-related injuries. However, it is unknown whether proximal and distal factors influence this movement pattern. The aim of this study was to investigate whether hip abduction strength, foot alignment, and ankle dorsiflexion range of motion (ROM) are associated with peak angles of hip adduction and internal rotation and knee abduction during the preparation and landing phases of a classical ballet jump. DESIGN Cross-sectional study. METHODS Forty-one healthy amateur ballet dancers were included. Hip abduction strength was evaluated isometrically using a handheld dynamometer, foot alignment was determined by the shank-forefoot alignment, and weight-bearing ankle dorsiflexion ROM was measured by performing the lunge test. Peak hip and knee angles were analyzed 3-dimensionally during the preparation and landing phases of a single-leg jump. A Pearson correlation matrix was used to investigate the association of hip abduction strength, shank-forefoot alignment, and ankle dorsiflexion ROM with peak angles of hip adduction and internal rotation and knee abduction during the preparation and landing phases of the jump. RESULTS Greater hip abduction strength was associated with greater peak hip internal rotation angle (r = .43, P < .05), but not with peak hip adduction and knee abduction angles during the preparation phase of the jump. There were no associations of shank-forefoot alignment and ankle dorsiflexion ROM with peak hip and knee angles during the preparation (r = -.23 to .36, P > .05) and landing (r = -.20 to .24, P > .05) phases of the jump. There was no association of hip abduction strength with peak hip and knee angles during the landing phase of the jump (r = -.28 to .16, P > .05). CONCLUSION Hip abductors strengthening, correction of foot misalignments, and increasing ankle dorsiflexion ROM may not prevent excessive hip and knee movements during a classical ballet single-leg jump in amateur dancers.
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Song Y, Li L, Dai B. Trunk Neuromuscular Function and Anterior Cruciate Ligament Injuries: A Narrative Review of Trunk Strength, Endurance, and Dynamic Control. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Carvalho C, Serrão FV, Pisani GK, Martinez AF, Serrão PRMDS. Frontal plane biomechanics during single-leg squat and hip strength in patients with isolated patellofemoral osteoarthritis compared to matched controls: A cross-sectional study. PLoS One 2022; 17:e0267446. [PMID: 35476842 PMCID: PMC9045627 DOI: 10.1371/journal.pone.0267446] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 04/09/2022] [Indexed: 01/08/2023] Open
Abstract
The patellofemoral compartment of the knee is the most frequently affected by osteoarthritis. However, there is a lack of biomechanics studies on patellofemoral osteoarthritis (PFOA). This study’s purpose was to compare the frontal plane biomechanics of the trunk and lower limb during the single-leg squat and isometric hip abductor torque in individuals with isolated PFOA and controls. Frontal plane kinematics during the single-leg squat were evaluated using a three-dimensional (3-D) motion analysis system. Isometric hip abductor torque was determined using a handheld dynamometer. Twenty individuals participated in the study (10 with PFOA and 10 controls). No significant differences between groups were found regarding age (mean ± SD, PFOA group = 51.8 ± 6.9 versus control group = 47.8 ± 5.5; mean difference = 4, 95% confidence interval [CI] = -1.9 to 9.9, p = 0.20) or body mass index (PFOA group = 27.6 ± 2.2 versus control group = 25.5 ± 2.5; mean difference = 2.1, 95% confidence interval [CI] = -0.1 to 4.3, p = 0.06). Compared to control, the PFOA group presented greater hip adduction in the descending and ascending phases of the single-leg squat at 45° (mean difference [95% CI] = 6.44° [0.39–12.48°], p = 0.04; mean difference [95% CI] = 5.33° [0.24–10.42°], p = 0.045, respectively) and 60° (mean difference [95% CI] = 8.44° [2.15–14.73°], p = 0.01; mean difference [95% CI] = 7.58° [2.1–13.06°], p = 0.009, respectively) of knee flexion. No significant differences between groups were found for the frontal plane kinematics of the trunk, pelvis or knee (p > 0.05). The PFOA group exhibited lower isometric hip abductor torque (mean difference [95% CI] = -0.34 Nm/kg [-0.67 to -0.01 Nm/kg], p = 0.04). The individuals with PFOA presented greater hip adduction than the control group, which could increase lateral patellofemoral joint stress at 45° and 60° of knee flexion in the descending and ascending phases of the single-leg squat. These individuals also exhibited hip abductor weakness in comparison to healthy controls.
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Affiliation(s)
- Cristiano Carvalho
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
- Physical Therapy Post-Graduate Program, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Fábio Viadanna Serrão
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
- Physical Therapy Post-Graduate Program, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Giulia Keppe Pisani
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
- Physical Therapy Post-Graduate Program, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Adalberto Felipe Martinez
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
- Physical Therapy Post-Graduate Program, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Paula Regina Mendes da Silva Serrão
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
- Physical Therapy Post-Graduate Program, Federal University of São Carlos, São Carlos, SP, Brazil
- * E-mail:
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Martinez AF, Scattone Silva R, Paschoal BLF, Souza LLA, Serrão FV. Association of Ankle Dorsiflexion and Landing Forces in Jumping Athletes. Sports Health 2021; 14:932-937. [PMID: 34961379 PMCID: PMC9631040 DOI: 10.1177/19417381211063456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Dorsiflexion range of motion restriction has been associated with patellar tendinopathy, but the mechanisms of how dorsiflexion restriction could contribute to knee overload remain unknown. HYPOTHESIS Peak ankle dorsiflexion and ankle dorsiflexion excursion are negatively associated with peak vertical ground-reaction force (vGRF) and loading rate, and with peak patellar tendon force and loading rate, and positively associated with peak ankle plantar flexor moment. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 4. METHODS Kinematic and kinetic data of 26 healthy recreational jumping athletes were measured during a single-leg drop vertical jump. Pearson's correlation coefficients were calculated to establish the association between peak ankle dorsiflexion and ankle dorsiflexion excursion with peak vGRF and vGRF loading rate, with peak patellar tendon force and patellar tendon force loading rate, and with peak ankle plantar flexor moment. RESULTS Ankle dorsiflexion excursion negatively correlated with peak vGRF loading rate (r = -0.49; P = 0.011) and positively correlated with peak ankle flexor plantar moment (r = 0.52; P = 0.006). In addition, there was a positive correlation between peak ankle dorsiflexion and peak vGRF (r = 0.39; P = 0.05). CONCLUSION Ankle kinematics are associated with vGRF loading rate, ankle flexor plantar moment and peak vGRF influencing knee loads, but no association was observed between ankle kinematics and patellar tendon loads. CLINICAL RELEVANCE These results suggest that increasing ankle dorsiflexion excursion may be an important strategy to reduce lower limb loads during landings but should not be viewed as the main factor for reducing patellar tendon force.
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Affiliation(s)
- Adalberto Felipe Martinez
- Department of Physical Therapy, Federal
University of São Carlos, São Carlos, Brazil,Adalberto Felipe Martinez,
Department of Physical Therapy, Federal University of São Carlos, Rod.
Washington Luís, Km 235–CEP, São Carlos, SP 13565-905, Brazil (
)
| | - Rodrigo Scattone Silva
- Postgraduate Program in Rehabilitation
Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do
Norte, Santa Cruz, Brazil
| | | | | | - Fábio Viadanna Serrão
- Department of Physical Therapy, Federal
University of São Carlos, São Carlos, Brazil
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Pinheiro YT, Barbosa GM, Fialho HRF, Silva CAM, Anunciação JDO, Silva HJDA, Souza MCD, Lins CADA. Does tension applied in kinesio taping affect pain or function in older women with knee osteoarthritis? A randomised controlled trial. BMJ Open 2020; 10:e041121. [PMID: 33328259 PMCID: PMC7745684 DOI: 10.1136/bmjopen-2020-041121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To analyse the short-term effects of kinesio taping (KT) with tension (KTT) or without tension (KTNT) in older women with knee osteoarthritis (KOA), and compare them to controls who did not receive KT. DESIGN Randomised controlled trial. SETTING University physiotherapy school clinic. PARTICIPANTS Forty-five older women (fifteen participants per group) with 66.8 (±5.6) years and clinical diagnosis of KOA were assessed pre, post and 3 days after intervention. INTERVENTIONS Participants were randomly allocated to KTT, who received two simultaneous applications of KT with tension on the knee and rectus femoris; KTNT, who received the same application as the KTT group, but without tension and a control group that attended a class on KOA. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome was pain intensity and secondary outcomes were knee-related health status, functional capacity, muscle strength and global rating of change. RESULTS No between-group differences were observed in pain after the first intervention (KTT vs KTNT: mean difference (MD), -1.8 points; 95% CI -4.2 to 0.5; KTT vs control: MD, -1.2 points; 95% CI -3.6 to 1.2; KTNT vs control: MD, 0.66 points; 95% CI -1.7 to 3.0) or 3 days later (KTT vs KTNT: MD, -1.3 points; 95% CI -3.7 to 1.0; KTT vs control: MD, 0.13 points; 95% CI -2.2 to 2.5; KTNT vs control: MD, 1.4 points; 95% CI -0.9 to 3.8). The lack of between-group differences was also found for secondary outcomes. CONCLUSION The short-term use of KT with or without tension in older woman with KOA had no beneficial effects on pain and function. These findings call into question the clinical use of KT as a non-pharmacological therapy for this population. TRIAL REGISTRATION NUMBER NCT03624075.
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Affiliation(s)
- Yago Tavares Pinheiro
- Postgraduate Program in Rehabilitation Sciences - Federal University of Rio Grandedo Norte, Faculty of Health Sciences of Trairi - (FACISA/UFRN), Santa Cruz, RN, Brazil
| | - Germanna Medeiros Barbosa
- Federal University of Rio Grande do Norte, Faculty of Health Sciences of Trairi - (FACISA/UFRN), Santa Cruz, RN, Brazil
| | | | - César Augusto Medeiros Silva
- Federal University of Rio Grande do Norte, Faculty of Health Sciences of Trairi - (FACISA/UFRN), Santa Cruz, RN, Brazil
| | | | - Hugo Jário de Almeida Silva
- Postgraduate Program in Rehabilitation Sciences - Federal University of Rio Grandedo Norte, Faculty of Health Sciences of Trairi - (FACISA/UFRN), Santa Cruz, RN, Brazil
| | - Marcelo Cardoso de Souza
- Postgraduate Program in Rehabilitation Sciences - Federal University of Rio Grandedo Norte, Faculty of Health Sciences of Trairi - (FACISA/UFRN), Santa Cruz, RN, Brazil
| | - Caio Alano de Almeida Lins
- Postgraduate Program in Rehabilitation Sciences - Federal University of Rio Grandedo Norte, Faculty of Health Sciences of Trairi - (FACISA/UFRN), Santa Cruz, RN, Brazil
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Resende RA, Jardim SHO, Filho RGT, Mascarenhas RO, Ocarino JM, Mendonça LDM. Does trunk and hip muscles strength predict performance during a core stability test? Braz J Phys Ther 2020; 24:318-324. [PMID: 30954371 PMCID: PMC7351961 DOI: 10.1016/j.bjpt.2019.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 02/18/2019] [Accepted: 03/13/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND A better understanding about the relationship between trunk and hip muscles strength and core stability may improve evaluation and interventions proposed to improve core stability. OBJECTIVES To investigate if trunk and hip muscles strength predict pelvic posterior rotation during the bridge test with unilateral knee extension. METHODS This is a cross-sectional study. Sixty-one healthy individuals of both sexes (age, 28±6.4 years, weight, 66.5±10.9kg, height, 167±9.5cm) performed the bridge test with unilateral knee extension. The pelvic posterior rotation during the bridge test was obtained with two-dimensional video analysis. Isometric strength of the trunk extensors and rotators, and hip abductors, external and internal rotators and extensors were measured with a hand-held dynamometer. Multiple linear regression analysis was performed to identify if the strength variables could explain the pelvic posterior rotation during the test. RESULTS Muscle strength predicted pelvic posterior rotation during the bridge test (r=0.54; p=0.003). Strength of the trunk rotators (p=0.045) and hip internal rotators (p=0.015) predicted reduced magnitude of pelvic posterior rotation during the bridge test, and strength of the hip extensors (p=0.003) predicted increased magnitude of pelvic posterior rotation. CONCLUSIONS Trunk rotators and hip internal rotators and extensors strength predict 29% of the performance during the bridge test with unilateral knee extension. The strength of these muscles should be evaluated in individuals with increased pelvic posterior rotation during the bridge test with unilateral knee extension.
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Affiliation(s)
- Renan Alves Resende
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Rehabilitation Sciences Program, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
| | - Samuel Henrique Oliveira Jardim
- Graduate Program in Rehabilitation and Funcional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Renato Guilherme Trede Filho
- Graduate Program in Rehabilitation and Funcional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Rodrigo Oliveira Mascarenhas
- Graduate Program in Rehabilitation and Funcional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Juliana Melo Ocarino
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Rehabilitation Sciences Program, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Luciana De Michelis Mendonça
- Graduate Program in Rehabilitation and Funcional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
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Nunes GS, Barton CJ, Serrão FV. Impaired Knee Muscle Capacity Is Correlated With Impaired Sagittal Kinematics During Jump Landing in Women With Patellofemoral Pain. J Strength Cond Res 2020; 36:1264-1270. [PMID: 32341245 DOI: 10.1519/jsc.0000000000003616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Nunes, GS, Barton, CJ, and Serrão, FV. Impaired knee muscle capacity is correlated with impaired sagittal kinematics during jump landing in women with patellofemoral pain. J Strength Cond Res XX(X): 000-000, 2020-Knee and hip muscle capacity is impaired in women with patellofemoral pain (PFP), but little is known about the rate of force development (RFD) at the knee. Impaired muscle capacity may contribute to reduced sagittal plane movement at the knee and hip during jump landing in women with PFP. This study aimed to (a) compare knee extensor muscle capacity (including RFD), and hip abductor and extensor muscle capacity between women with and without PFP; and (b) evaluate the relationship between hip/knee muscle capacity and sagittal kinematics during single-legged drop jump landing in women with PFP. Fifty-two physically active women (26 with PFP and 26 controls) participated. Rate of force development (in %/ms), isometric, concentric, and eccentric torque (in N·m·kg × 100) were evaluated using isokinetic dynamometry, and knee and hip kinematics were evaluated using three-dimensional motion capture. Compared with the control group (CG), the PFP group (PFPG) presented lower isometric (12%, PFPG = 217.2 ± 46.0; CG = 246.5 ± 38.8; p = 0.02), concentric (21%, PFPG = 133.0 ± 42.6; CG = 169.2 ± 28.8; p < 0.01), and eccentric (17%, PFPG = 172.9 ± 56.7; CG = 208.4 ± 59.4; p = 0.03) knee extension torque; lower RFD until 30% (30%, PFPG = 0.57 ± 0.27; CG = 0.83 ± 0.37; p < 0.01) and 60% (31%, PFPG = 0.47 ± 0.24; CG = 0.67 ± 0.33; p = 0.01) of maximal isometric torque; and lower concentric hip abduction (13%, PFPG = 94.7 ± 19.1; CG = 108.4 ± 17.5; p = 0.01) and extension (17%, PFPG = 134.4 ± 34.3; CG = 162.6 ± 38.0; p < 0.01) torque. Significant correlations between reduced RFD for knee extension and reduced sagittal plane knee/hip range of motion during landing were identified (r = 0.39-0.49). In conclusion, women with PFP have impaired knee extensor isometric and dynamic strength, and RFD. Impaired knee extensor RFD is associated with a stiffer landing strategy (reduced movement).
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Affiliation(s)
- Guilherme S Nunes
- Department of Physiotherapy, São Carlos Federal University, São Carlos, Brazil.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Christian J Barton
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.,Department of Surgery, St Vincent's Hospital, University of Melbourne, Melbourne, Australia
| | - Fábio V Serrão
- Department of Physiotherapy, São Carlos Federal University, São Carlos, Brazil
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