The relationship between trunk and lower limb kinematics in healthy females versus males is unclear since trunk kinematics in the frontal and transverse planes have not been systematically examined with lower limb kinematics. The aim of this study was to investigate the existence of different multi-joints movement strategies between genders during a single leg squat. We expected that compared to males, females would have greater trunk and pelvis displacement due to less trunk control and display hip and knee movement consistent with medial-collapse (i.e. greater hip adduction, hip medial rotation, knee abduction, knee lateral rotation) on the weight-bearing limb. 9 females and 10 males participated in the study. Kinematic data were collected using an 8-camera, 3D-motion-capture-system. Trunk relative to pelvis, pelvis relative to the laboratory, hip and knee angles in three planes (sagittal, frontal and transverse) were examined at two time events relevant to knee joint mechanics: 45° of knee flexion and peak knee flexion. Females flexed their trunk less than males and rotated their trunk and pelvis toward the weight-bearing limb more than males. Females also displayed greater hip adduction and knee abduction than males. Taken together these results suggest that females and males used different movement strategies during a single leg squat. Females displayed a trunk and pelvic movement pattern that may put them at risk of knee injury and pain.

Our findings suggest that exteroceptive cues are provided by the central visual field and are used in a feed-forward manner to plan the gait adaptations required to safely negotiate an obstacle, whereas exproprioceptive information is provided by the peripheral visual field and used online to "fine tune" adaptive gait. The loss of the upper and lower peripheral visual fields together had a greater effect on adaptive gait compared with the loss of the lower visual field alone, likely because of the absence of lamellar flow visual cues used to control egomotion.

No abstract

Study Design Controlled laboratory study Objectives To compare hip and knee kinematics and pain during a single limb squat between 3 movement conditions (‘usual’, ‘exaggerated’ dynamic knee valgus, ‘corrected’ dynamic knee valgus) in females with patellofemoral pain. Background Altered kinematics (increased hip adduction, hip medial rotation, knee abduction, and knee lateral rotation, collectively termed “dynamic knee valgus”) have been proposed to contribute to patellofemoral pain, however cross-sectional study designs prevent interpreting a causal link between kinematics and pain. Methods Twenty females with patellofemoral pain who demonstrated observable dynamic knee valgus performed single limb squats under ‘usual’, ‘exaggerated’, and ‘corrected’ movement conditions. Pain during each condition was assessed using a 0-100 mm visual analog scale. Hip and knee frontal and transverse plane angles at peak knee flexion and pain levels were compared using repeated measures, 1-way ANOVAs. Within condition associations between kinematic variables and pain were determined using Pearson correlation coefficients. Results In the ‘exaggerated’ compared to the ‘usual’ condition, increases were detected in hip medial rotation (mean +/-SD, 5.8±3.2°, P<.001), knee lateral rotation (5.5±4.9°, P<.001), and pain (8.5±10.8mm, P=.007). In the ‘corrected’ compared to the ‘usual’ condition, decreases were detected in hip adduction (3.5±3.7°, P=.001) and knee lateral rotation (1.6±2.8°, P=.06; however, average pain was not decreased (1.2±14.8mm, P=1.0). Pain was correlated with knee lateral rotation in the ‘usual’ (r=−0.47, P=.04) and ‘exaggerated’ (r=−0.49, P=.03) conditions. In the ‘corrected’ condition, pain was correlated with hip medial rotation (r=0.44, P=.05) and knee adduction (r=0.52, P=.02). Conclusion Avoiding dynamic knee valgus may be an important component of rehabilitation programs in females with patellofemoral pain, as this movement pattern is associated with increased pain.

Visual assessments were made reliably by experienced and novice testers. Additionally, movement-pattern categories based on visual assessments were in excellent agreement with objective methods to measure FPPA change. Therefore, visual assessments can be used in the clinic to assess movement patterns associated with musculoskeletal disorders and in large epidemiologic studies to assess the association between lower extremity movement patterns and musculoskeletal injury.