Comparison of two methods of determining patellofemoral joint stress during dynamic activities

Kernozek, Thomas W.; Vannatta, C. Nathan; Bogert, Antonie J. van den

doi:10.1016/j.gaitpost.2015.05.017

Cited by 20 publications

(16 citation statements)

References 15 publications

(25 reference statements)

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“…As this study found no significant differences between limbs or groups for the motion and moments in the transverse and frontal plane, it is likely to have had to influence on the results. Another limitation was that the model may have underestimated the quadriceps muscle force in comparison to models that account for co-contraction of the muscles that surround the knee joint (30). This means the absolute values provided in this paper may have underestimated the PFJ contact forces.…”

Section: Discussionmentioning

confidence: 89%

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Patellofemoral Joint Loads During Running at the Time of Return to Sport in Elite Athletes With ACL Reconstruction

2017

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Section: Discussionmentioning

confidence: 89%

“…Second, the model may have underestimated the quadriceps muscle force in comparison to models that account for co-contraction of the muscles that surround the knee joint. 15 This means that the absolute values provided in this article may have underestimated the PFJ contact forces.…”

Section: Discussionmentioning

confidence: 92%

Patellofemoral Joint Loads During Running at the Time of Return to Sport in Elite Athletes With ACL Reconstruction

2017

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“…Some studies have attempted to identify overload patterns when there was a change in the distance between the feet, in the frontal plane, and during the squatting movement, but no difference in the patellofemoral ligament overload has been demonstrated with the distance between feet [ 22 , 35 , 50 ]. However, other authors describe that there would be tension overload on the patellofemoral joint when there is a contraction of the quadriceps muscle, regardless of different distances [ 22 , 25 , 26 , 36 ].…”

Section: Discussion Summary Of Evidencementioning

confidence: 99%

“…(Tibiofemoral joint kinematics. )/“Ground reaction forces (A—Tibiofemoral joint moment, B—Patellofemoral joint reaction force) Patellofemoral joint stress.” Healthy Subject Collegiate women athletes Female: 5 NA Female: 19 ± 1.4 Female: 23.49 Patellofemoral joint stress at knee Flexion: 72.8° = 4319.2 N 91.5° = 5065.7 N 109.7° = 5097.1 N NA [ 36 ] Squatting Running 1—joint kinematics 2—kinetics 3—muscle forces pPFJS indicates the peak patellofemoral joint stress (MPa); PFJS-TI = patellofemoral joint stress time integral (MPa s); (pQF) indicates the peak quadriceps force (pQF) Healthy subject Subject with strength training experience Female: 11 NA Overall: 22 ± 1.8 Overall: 22.47 Squat trials Methods NA ID—Inverse dynamics IDO—Inverse dynamics and static optimisation PPFJS 9.81 (sd 3.36) 17.06 (sd 4.34) PFJS-TI 7.51 (sd 1.98) 12.87 (sd 2.33) pQF 3.81 (sd 0.72) 5.16 (sd 0.82) [ 37 ] “Squat with three displacements. Displacing the Knee anteriorly (AP malaligned), displacing the Knee medially (ML malaligned).…”

Section: Table A1mentioning

confidence: 99%

Patellofemoral Pain Syndrome Risk Associated with Squats: A Systematic Review

Pereira

Baptista

Conceição

et al. 2022

IJERPH

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Patellofemoral pain syndrome (PFPS) is highly prevalent; it can cause severe pain and evolve into progressive functional loss, leading to difficulties performing daily tasks such as climbing and descending stairs and squatting. This systematic review aimed to find evidence, in the literature, of squat movements that can cause or worsen PFPS. This work was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, and its protocol was registered in PROSPERO (CRD42019128711). From the 6570 collected records, 37 were included. From these 37 articles, 27 present a causal relationship between knee flexion and PFPS, 8 describe a relationship, considering the greater existence of muscle contractions, and one article did not describe this relationship in its results. The main limitations stem from the fact that different studies used different evaluation parameters to compare the force exerted on the patellofemoral joint. Furthermore, most studies are focused on sports populations. After analysing the included works, it was concluded that all squat exercises can cause tension overload in the knee, especially with a knee flexion between 60° and 90° degrees. The main causal/worsening factors of PFPS symptoms are the knee translocation forward the toes (on the same body side) when flexing the knee, and the muscle imbalance between the thigh muscles.

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“…2,[8][9][10] Musculoskeletal modeling studies have investigated PFJS during various movements to characterize this loading. [11][12][13][14] Patellofemoral (PF) joint stress is determined by dividing the PF joint reaction force by the PF contact area. Knee flexion angle influences PF joint contact area 2,15 while the interaction of quadriceps force and knee flexion influence the magnitude of PF joint reaction force.…”

Section: Introductionmentioning

confidence: 99%

Effect of Heel Lifts on Patellofemoral Joint Stress During Running

Mestelle

Kernozek

Adkins

et al. 2017

Intl J Sports Phys Ther

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Background: Patellofemoral pain is a debilitating injury for many recreational runners. Excessive patellofemoral joint stress may be the underlying source of pain and interventions often focus on ways to reduce patellofemoral joint stress.Purpose: Heel lifts have been used as an intervention within Achilles tendon rehabilitation programs and to address leg length discrepancies. The purpose of this study was to examine the effect of running with heel lifts on patellofemoral joint stress, patellofemoral stress impulse, quadriceps force, step length, cadence, and other related kinematic and spatiotemporal variables. Study Design: A repeated-measures research designMethods: Sixteen healthy female runners completed five running trials in a controlled laboratory setting with and without 11mm heel lifts inserted in a standard running shoe. Kinetic and kinematic data were used in combination with a static optimization technique to estimate individual muscle forces. These data were inserted into a patellofemoral joint model which was used to estimate patellofemoral joint stress and other variables during running.Results: When running with heel lifts, peak patellofemoral joint stress and patellofemoral stress impulse were reduced by a 4.2% (p=0.049) and 9.3% (p=0.002). Initial center of pressure was shifted anteriorly 9.1% when running with heel lifts (p<0.001) despite all runners utilizing a heel strike pattern. Dorsiflexion at initial contact was reduced 28% (p=0.016) when heel lifts were donned. No differences in step length and cadence (p>0.05) were shown between conditions. Conclusions: Heel lift use resulted in decreased patellofemoral joint stress and impulse without associated changes in step length or frequency, or other variables shown to influence patellofemoral joint stress. The center of pressure at initial contact was also more anterior using heel lifts. The use of heel lifts may have therapeutic benefits for runners with patellofemoral pain if the primary goal is to reduce patellofemoral joint stress. Level of Evidence: 3b

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Comparison of two methods of determining patellofemoral joint stress during dynamic activities

Cited by 20 publications

References 15 publications

Patellofemoral Joint Loads During Running at the Time of Return to Sport in Elite Athletes With ACL Reconstruction

Patellofemoral Joint Loads During Running at the Time of Return to Sport in Elite Athletes With ACL Reconstruction

Patellofemoral Pain Syndrome Risk Associated with Squats: A Systematic Review

Effect of Heel Lifts on Patellofemoral Joint Stress During Running

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