Acute Responses of Strength and Running Mechanics to Increasing and Decreasing Pain in Patients With Patellofemoral Pain

Bazett-Jones, David M.; Huddleston, Wendy E.; Cobb, Sidney; O’Connor, Kristian M.; Earl-Boehm, Jennifer E.

doi:10.4085/1062-6050-53.3.04

Cited by 11 publications

(8 citation statements)

References 54 publications

(78 reference statements)

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“…Therapeutic interventions, such as transcutaneous electrical neural stimulation or cryotherapy, in addition to traditional strength training, may improve quadriceps activation for physically active individuals suffering from PFP and impaired quadriceps activation. 47 We concede that many clinicians do not have access to technical instrumentation required to objectively measure the CAR; however, other measures can/should be considered as potential surrogates. We recommend that researchers explore relationships between the CAR and potential CAR surrogates for PFP patients.…”

Section: Discussionmentioning

confidence: 99%

Biomechanics Differ for Individuals With Similar Self-Reported Characteristics of Patellofemoral Pain During a High-Demand Multiplanar Movement Task

Seeley¹,

Son²,

Kim³

et al. 2021

Journal of Sport Rehabilitation

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Context: Patellofemoral pain (PFP) is often categorized by researchers and clinicians using subjective self-reported PFP characteristics; however, this practice might mask important differences in movement biomechanics between PFP patients. Objective: To determine whether biomechanical differences exist during a high-demand multiplanar movement task for PFP patients with similar self-reported PFP characteristics but different quadriceps activation levels. Design: Cross-sectional design. Setting: Biomechanics laboratory. Participants: A total of 15 quadriceps deficient and 15 quadriceps functional (QF) PFP patients with similar self-reported PFP characteristics. Intervention: In total, 5 trials of a high-demand multiplanar land, cut, and jump movement task were performed. Main Outcome Measures: Biomechanics were compared at each percentile of the ground contact phase of the movement task (α = .05) between the quadriceps deficient and QF groups. Biomechanical variables included (1) whole-body center of mass, trunk, hip, knee, and ankle kinematics; (2) hip, knee, and ankle kinetics; and (3) ground reaction forces. Results: The QF patients exhibited increased ground reaction force, joint torque, and movement, relative to the quadriceps deficient patients. The QF patients exhibited: (1) up to 90, 60, and 35 N more vertical, posterior, and medial ground reaction force at various times of the ground contact phase; (2) up to 4° more knee flexion during ground contact and up to 4° more plantarflexion and hip extension during the latter parts of ground contact; and (3) up to 26, 21, and 48 N·m more plantarflexion, knee extension, and hip extension torque, respectively, at various times of ground contact. Conclusions: PFP patients with similar self-reported PFP characteristics exhibit different movement biomechanics, and these differences depend upon quadriceps activation levels. These differences are important because movement biomechanics affect injury risk and athletic performance. In addition, these biomechanical differences indicate that different therapeutic interventions may be needed for PFP patients with similar self-reported PFP characteristics.

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Section: Discussionmentioning

confidence: 99%

Biomechanics Differ for Individuals With Similar Self-Reported Characteristics of Patellofemoral Pain During a High-Demand Multiplanar Movement Task

Seeley¹,

Son²,

Kim³

et al. 2021

Journal of Sport Rehabilitation

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show abstract

“…However, delayed onset of vastus medialis oblique relative to vastus lateralis has also been shown in patients with PFPS [ 6 , 47 ]. Therefore, it is assumed that quadriceps inhibition may be the resultant of acute pain rather than being related to the presence of a chronic condition like PFPS [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of local exercise therapy versus spinal manual therapy in patients with patellofemoral pain syndrome: medium term follow-up results of a randomized controlled trial

Scafoglieri

Broeck

Willems

et al. 2021

BMC Musculoskelet Disord

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Background Increasing evidence has shown benefits of spinal manipulations in patients with patellofemoral pain syndrome (PFPS). There is scarcity regarding medium term effects of spinal manual therapy on outcome measures in PFPS patients. Therefore, the aim of the present study was to compare the effectiveness of local exercise therapy and spinal manual therapy for knee pain, function and maximum voluntary peak force (MVPF) velocity of the quadriceps in PFPS patients. Methods Forty-three patients with PFPS were randomly assigned to a local exercise or spinal manual therapy group. The local exercise group received six sessions (one session per week) of supervised training of the knee-and hip muscles with mobilization of the patellofemoral joint. The spinal manual therapy group received six interventions (one intervention per week) of high velocity low thrust manipulations at the thoracolumbar region, sacroiliac joint, and/or hip. All patients were also asked to do home exercises. Maximum, minimum and current pain were measured using the visual analogue scale. Function was assessed with the anterior knee pain scale (AKPS) and MPFV was recorded using a Biodex System 3 dynamometer. Patients were assessed before intervention, after 6 weeks of intervention and after 6 weeks of follow-up. Between-group differences at assessments were analysed by way of analysis of covariance with Bonferroni correction. Results Pain and functionality improved more following spinal manipulative therapy than local exercise therapy. After 6 weeks of intervention the between-group difference (local versus spinal) for maximal pain was 23.4 mm [95% CI: 9.3, 37.6; effect size (ES): 1.04] and − 12.4 [95% CI: − 20.2, − 4.7; ES: 1.00] for the AKPS. At 6 weeks of follow-up the between-group difference for maximal pain was 18.7 mm [95% CI: 1.4, 36.0; ES: 0.68] and − 11.5 [95% CI: − 19.9, − 3.3; ES: − 0.87] for the AKPS. Conclusions This study suggests that spinal manual therapy is more effective than local exercise therapy in improving pain and function in patients with PFPS in the medium term. We suggest for future research to investigate whether combining local exercise therapy and spinal manual therapy is more effective than either single intervention on its own. This clinical trial study was approved by the Medical Ethics Committee METC Z under registration number NL57207.096. and registered retrospectively in ClinicalTrials.gov PRS with registration ID number NCT04748692 on the 10th of February 2021.

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“…70,71 The PFP patients also run with decreased plantar flexion torque and angle during pushoff. 52,72 Researchers have acutely manipulated PFP levels to more clearly understand biomechanical effects of PFP. [72][73][74] The PFP levels were acutely increased and decreased using a single-leg squat exercise and TENS therapy.…”

Section: Knee Pain and Running Biomechanicsmentioning

confidence: 99%

“…52,72 Researchers have acutely manipulated PFP levels to more clearly understand biomechanical effects of PFP. [72][73][74] The PFP levels were acutely increased and decreased using a single-leg squat exercise and TENS therapy. 72 Fitting with some EKP running research, 52 internal hip abduction and extension moments and peak plantar flexion angle during running decreased as PFP increased.…”

Section: Knee Pain and Running Biomechanicsmentioning

confidence: 99%

A Review of the Relationships Between Knee Pain and Movement Neuromechanics

Seeley¹,

Lee²,

Son³

et al. 2022

Journal of Sport Rehabilitation

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Context: Knee injury and disease are common, debilitating, and expensive. Pain is a chief symptom of knee injury and disease and likely contributes to arthrogenic muscle inhibition. Joint pain alters isolated motor function, muscular strength, and movement biomechanics. Because knee pain influences biomechanics, it likely also influences long-term knee joint health. Objective: The purpose of this article is 2-fold: (1) review effects of knee pain on lower-extremity muscular activation and corresponding biomechanics and (2) consider potential implications of neuromechanical alterations associated with knee pain for long-term knee joint health. Experimental knee pain is emphasized because it has been used to mimic clinical knee pain and clarify independent effects of knee pain. Three common sources of clinical knee pain are also discussed: patellofemoral pain, anterior cruciate ligament injury and reconstruction, and knee osteoarthritis. Data Sources: The PubMed, Web of Science, and SPORTDiscus databases were searched for articles relating to the purpose of this article. Conclusion: Researchers have consistently reported that knee pain alters neuromuscular activation, often in the form of inhibition that likely occurs via voluntary and involuntary neural pathways. The effects of knee pain on quadriceps activation have been studied extensively. Knee pain decreases voluntary and involuntary quadriceps activation and strength and alters the biomechanics of various movement tasks. If allowed to persist, these neuromechanical alterations might change the response of articular cartilage to joint loads during movement and detrimentally affect long-term knee joint health. Physical rehabilitation professionals should consider neuromechanical effects of knee pain when treating knee injury and disease. Resolution of joint pain can likely help to restore normal movement neuromechanics and potentially improve long-term knee joint health and should be a top priority.

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Acute Responses of Strength and Running Mechanics to Increasing and Decreasing Pain in Patients With Patellofemoral Pain

Cited by 11 publications

References 54 publications

Biomechanics Differ for Individuals With Similar Self-Reported Characteristics of Patellofemoral Pain During a High-Demand Multiplanar Movement Task

Biomechanics Differ for Individuals With Similar Self-Reported Characteristics of Patellofemoral Pain During a High-Demand Multiplanar Movement Task

Effectiveness of local exercise therapy versus spinal manual therapy in patients with patellofemoral pain syndrome: medium term follow-up results of a randomized controlled trial

A Review of the Relationships Between Knee Pain and Movement Neuromechanics

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