Bilateral Rearfoot Asymmetry and Anterior Knee Pain Syndrome

Livingston, Lori A.; Mandigo, James L.

doi:10.2519/jospt.2003.33.1.48

Cited by 25 publications

(26 citation statements)

References 39 publications

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“…This finding is in agreement with other studies, which found no difference between rearfoot posture in stance and the occurrence of PFPS 9,13,18 . Although the reliability of the rearfoot angle found in the present study was excellent, previous reports of reliability have been poor for this measure 29 .…”

Section: Discussionsupporting

confidence: 83%

“…A systematic review, which evaluated risk factors associated with PFPS, stated that the actual knowledge is still insufficient to confirm the relationship between rearfoot alignment and this dysfunction, therefore, more evidences need to be established 19 . Although widely recommended in clinical practice and in theoretical thought 1,[5][6][7] , the scientific basis for the association of rearfoot and Q angles with PFPS is still controversial 8,9,19 . Studies with a sample size large enough to allow inferences from the results are necessary to investigate the association between clinical static measures and PFPS.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, static clinical measurements are widely used in PFPS physical examination as this syndrome is supposedly related to lower extremity static misalignment [5][6][7] . The static postural alignment of the rearfoot and the Q angle are examples of clinical static measurements, which are frequently employed to evaluate individuals during PFPS rehabilitation 5,[7][8][9] . Theoretically, the static postural alignment of the rearfoot is related to the Q angle, in such a way that excessive and/or prolonged subtalar pronation could induce medial rotation of the tibia and, therefore, greater femoral medial rotation in a closed kinetic chain 10 .…”

Section: Introductionmentioning

confidence: 99%

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Clinical rearfoot and knee static alignment measurements are not associated with patellofemoral pain syndrome

Aliberti

Costa²,

João³

et al. 2012

Fisioter. Pesqui.

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The aim of the present study was to investigate the association between the patellofemoral pain syndrome and the clinical static measurements: the rearfoot and the Q angles. The design was a cross-sectional, observational, case-control study. We evaluated 77 adults (both genders), 30 participants with patellofemoral pain syndrome, and 47 controls. We measured the rearfoot and Q angles by photogrammetry. Independent t-tests were used to compare outcome continuous measures between groups. Outcome continuous data were also transformed into categorical clinical classifications, in order to verify their statistical association with the dysfunction, and χ2 tests for multiple responses were used. There were no differences between groups for rearfoot angle [mean differences: 0.2º (95%CI -1.4-1.8)] and Q angle [mean differences: -0.3º (95%CI -3.0-2.4). No associations were found between increased rearfoot valgus [Odds Ratio: 1.29 (95%CI 0.51-3.25)], as well as increased Q angle [Odds Ratio: 0.77 (95%CI 0.31-1.93)] and the patellofemoral pain syndrome occurrence. Although widely used in clinical practice and theoretically thought, it cannot be affirmed that increased rearfoot valgus and increased Q angle, when statically measured in relaxed stance, are associated with patellofemoral pain syndrome (PFPS). These measures may have limited applicability in screening of the PFPS development.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical rearfoot and knee static alignment measurements are not associated with patellofemoral pain syndrome

Aliberti

Costa²,

João³

et al. 2012

Fisioter. Pesqui.

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“…Structural anomalies and lower extremity malalignment are often examined as associative factors for PFPS in case-control studies. 1,[25][26][27]31 In the literature, female gender is often suggested to be a risk factor for PFPS. 13,21,33,43 Findings of 1 prospective study included in this review support the notion that females are at higher risk for PFPS than males.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Patellofemoral Pain Syndrome: A Systematic Review

Lankhorst¹,

Bierma-Zeinstra²,

Middelkoop³

2012

Journal of Orthopaedic & Sports Physical Therapy

208

147

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Patellofemoral pain syndrome (PFPS) is the most frequently diagnosed condition in patients younger than 50 years with knee complaints. While the general practitioner sees an average of 5 or 6 new patients with PFPS per year , the incidence of PFPS in the general population is still unknown. 4,37 Women have a higher incidence of PFPS than men, 33 and incidence rates of 25% to 43% have been reported in sports medicine and during basic military T T STUDY DESIGN: Systematic review. T T OBJECTIVES:To systematically outline the risk factors for patellofemoral pain syndrome (PFPS). T T BACKGROUND:PFPS is the most commonly diagnosed condition in young individuals with knee complaints. High incidence among athletes suggests a possibility of prevention. The first step toward prevention is identification of possible risk factors. T T METHODS:Prospective studies that included 20 or more patients with PFPS and examined at least 1 possible risk factor for PFPS were included. An assessment list was applied to evaluate the quality of the studies. A meta-analysis was conducted using a random-effects model. Significant differences were based on calculated mean differences, with matching 95% confidence intervals (CIs). For dichotomous data, odds ratios or relative risks were calculated. T T RESULTS:Of the 3845 potentially relevant articles, 7 were included in this review. These studies examined a total of 135 variables, and pooling was possible for 13 potential risk factors. The pooled data showed that knee extension peak torques were significantly lower in the PFPS group than in controls. Mean differences in torque, with negative differences reflecting lower means in the PFPS group, were as follows: (a) standardized relative to body weight at 60°/s, -0.24 Nm (95% CI: -0.39, -0.09); (b) standardized relative to body weight at 240°/s, -0.11 Nm (95% CI: -0.17, -0.05); (c) standardized relative to body mass index at 60°/s, -0.84 Nm (95% CI: -1.23, -0.44); (d) standardized relative to body mass index at 240°/s, -0.32 Nm (95% CI: -0.52, -0.12); (e) nonstandardized in a concentric mode at 60°/s, -17.54 Nm (95% CI: -25.53, -9.54); (f) nonstandardized in a concentric mode at 240°/s, -7.72 Nm (95% CI: -12.67, -2.77). T T CONCLUSION:Weaker knee extension strength, expressed by peak torque, appears to be a risk factor for PFPS, based on meta-analyses of pooled results from multiple studies. Because several other risk factors for PFPS were described only in single studies, these additional risk factors, as well as those with conflicting evidence, need to be confirmed in future studies. Prognosis, level 1a-. J Orthop Sports Phys Ther 2012;42(2):81-94, Epub 25 October 2011. doi:10.2519/jospt.2012 14,34 T T LEVEL OF EVIDENCE:The term patellofemoral pain syndrome is commonly used to describe a condition of anterior knee pain. Although there is no consensus on the terminology, various synonyms are used for PFPS. 12 The guidelines of the Dutch College of General Practitioners describe PFPS as a pain in or around the patella. This pain increas...

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“…[7][8][9][10][11][12][13][14] Conversely, measuring the uninjured (retrospectively) or only a representative side (prospectively) also has been questioned, because studies of isolated anatomic factors have indicated that bilateral symmetry cannot always be assumed. [15][16][17] However, there remains a paucity of data that has critically examined the prevalence and magnitude of bilateral asymmetries in lowerlimb anatomic characteristics to aid clinicians and researchers in making these determinations.…”

Section: Introductionmentioning

confidence: 99%