Influence of patellofemoral pain syndrome on plantar pressure in the foot rollover process during gait

Abstract

BACKGROUND:Patellofemoral Pain Syndrome is one of the most common knee disorders among physically active young women. Despite its high incidence, the multifactorial etiology of this disorder is not fully understood.OBJECTIVES:To investigate the influence of Patellofemoral Pain Syndrome on plantar pressure distribution during the foot rollover process (i.e., the initial heel contact, midstance and propulsion phases) of the gait.MATERIALS AND METHODS:Fifty-seven young adults, including 22 subjects with Patellofemoral Pain Syndrome (30 ± 7 years, 165 ± 9 cm, 63 ± 12 kg) and 35 control subjects (29 ± 7 years, 164 ± 8 cm, 60 ± 11 kg), volunteered for the study. The contact area and peak pressure were evaluated using the Pedar-X system (Novel, Germany) synchronized with ankle sagittal kinematics.RESULTS:Subjects with Patellofemoral Pain Syndrome showed a larger contact area over the medial (p = 0.004) and central (p = 0.002) rearfoot at the initial contact phase and a lower peak pressure over the medial forefoot (p = 0.033) during propulsion when compared with control subjects.CONCLUSIONS:Patellofemoral Pain Syndrome is related to a foot rollover pattern that is medially directed at the rearfoot during initial heel contact and laterally directed at the forefoot during propulsion. These detected alterations in the foot rollover process during gait may be used to develop clinical interventions using insoles, taping and therapeutic exercise to rehabilitate this dysfunction.

Emerging flexible and wearable physical sensing platforms for healthcare and biomedical applications

“…For instance, physical sensors targeted for applications associated with standing and sitting motions need to account for the pressures exerted by these actions, which range widely from 10 to 500 kPa (Ref. 126). In fact, these ranges of pressures are unique to different bodily actions.…”

Does McConnell Taping or the Stability Through External Rotation of the Femur (Serf) Strap Affect Rearfoot Plantar Loading Patterns During Walking in Healthy Adults?

“…A larger sample size may have resulted in a significant difference in MH maximum pressures between the 3 conditions. Excessive rearfoot pronation is frequently associated with PFPS development [31] so individuals with PFPS present with larger contact areas at the medial rearfoot [14,28] …”

“…Excessive and/or prolonged rearfoot pronation has been shown to lead to excessive medial rotation of the tibia and the femur in a closed kinetic chain [13]. When the femur rotates medially, the compression between the lateral side of the patella and the femur increases, resulting in increased patellofemoral joint stress [13][14][15][16][17][18]. The forces on the knee during weightbearing activities are transmitted from the foot to the knee.…”

“…By correcting excessive rearfoot pronation, external tibial rotation is increased, eliciting a relative medial patellar glide [19]. Higher loading on the medial areas of the plantar surface of the foot during running and other weight-bearing activities have been suggested to be important factors for lower limb injuries [14,17]. Willems et al (2006) [20] and Willems et al (2007) [21] found increased pronation, accompanied with more pressure on the medial side of the rearfoot in healthy people who developed exerciserelated lower leg pain during barefoot running.…”

Reliability and differentiation capability of dynamic and static kinematic measurements of rearfoot eversion in patellofemoral pain

“…During the stance phase of gait or stair climbing, an everted rearfoot could lead to excessive internal rotation of the tibia which can induce a compensatory internal rotation of the femur, increasing patellofemoral joint stress (Aliberti et al, 2011). Despite rearfoot alterations having been used in assessments of subjects with PFP through static clinical tests (Powers et al, 1995(Powers et al, , 1999, the adaptations generally appear in dynamic conditions (Barton et al, 2009).…”