Background
Patellofemoral pain syndrome (PFPS) is the most common complaint in female volleyball players. Larger quadriceps femoris angle (Q angle) has been implicated as a source of patellofemoral pain but values measured during functional tasks (dynamic Q angle) have not been adequately documented in the literature.
Objective
With this study, we attempt to determine whether excessive Q angle during a functional task is related with PFPS.
Design
A correlational study.
Setting
The study was conducted among high performance female athletes all participating in the Portuguese A1 Division.
Participants
50 female volleyball players participated. They were included in one of two groups, according to the presence or absence of patellofemoral pain.
Interventions
Static Q angle was measured using a goniometer. Subjects were videotaped during the execution of simple functional tasks and dynamic Q angle was determined ‘a posteriori’ using a video analysis program.
Main outcome measurements
A correlation was examined between static and dynamic Q angle and the prevalence of patellofemoral pain.
Results
When averaged across all conditions, the average dynamic Q-angle was significantly higher in the PFP group compared to the control group (34.9° vs 22.3°). We found a relationship between larger dynamic Q angles and PFPS (r=-0.517) that remained significant (p<0.01) when the static Q angle was normal.
Conclusions
The results substantiate the belief that lower extremity motion during dynamic tasks may increase Q-angle and the lateral force acting on the patella, even on individuals with a ‘normal’ static Q-angle. Static Q-angle measurements in this study showed little relationship to dynamic Q-angle measurements and with the presence of PFP.
Introduction: Increased joint load on the medial compartment of the knee during gait is a mechanical factor responsible for pain and progression of medial knee osteoarthritis. The knee external adductor moment of force is a kinetic parameter that correlates with the joint load in the medial compartment. Objective: The aim of this study was to conduct a narrative review of the biomechanics strategies during gait of individuals with medial knee osteoarthritis that reduce external adductor moment of force of the knee. Methods: The review of the literature was conducted in the databases MEDLINE, PUBMED and PEDro and included articles published between 2000 and 2011. It was selected transversal, theoretical, correlational and longitudinal studies as well as controlled clinical trials. Results: Decreased gait velocity, increased external rotation of the foot, increased internal abductor moment force of the hip and lateral trunk inclination to the side of the support limb are compensatory strategies used to reduce the external adductor moment of force of the knee during gait of individuals with medial knee osteoarthritis. The lateral trunk inclination may be beneficial in a short term, however it decreases the activity of the abductors muscles of the hip during the support phase of the gait favoring compensation that could result in the progression of medial knee osteoarthritis. Conclusion: Strengthening of the abductors muscles of the hip reduces pain, improves the function and prevents compensations that in a long term could possibly accelerate the progression of the medial knee osteoarthritis.
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