Gait retraining versus foot orthoses for patellofemoral pain: a pilot randomised clinical trial

Bonacci, Jason; Hall, Michelle; Saunders, Natalie; Vicenzino, Bill

doi:10.1016/j.jsams.2017.09.187

Cited by 36 publications

(70 citation statements)

References 28 publications

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“…More than 70% of long-distance runners adopt the heel strike pattern [24,25]. Horvais noted that heel strikers use the midfoot or forefoot strike pattern during the adaptation process when wearing minimalist shoes for the first time [26]. In the current study, the vGRF graph showed two peaks, and the foot inclination angle at the point of foot strike was positive.…”

Section: Discussionsupporting

confidence: 43%

Patellofemoral Joint Loads during Running Immediately Changed by Shoes with Different Minimalist Indices: A Cross-sectional Study

et al. 2019

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Purpose: Given the high incidence of patellofemoral pain syndrome (PFPS) in runners, this study aimed to investigate the immediate effect of shoes with different minimalist indices (MI) on the mechanical loads of the patellofemoral joint. Methods: Fifteen healthy male rearfoot strike runners were recruited to complete overground running trials at 3.33 m/s (±5%) in two running shoe conditions (MI = 26% versus MI = 86%). The amount of ten Vicon infrared cameras (100 Hz) and two Kistler force plates (1000 Hz) were used to collect kinematic and ground reaction force (GRF) data simultaneously. Quadriceps strength, patellofemoral contact force, patellofemoral contact area, and patellofemoral contact stress were calculated. Results: No significant differences were observed in the impact force and the second peak of the vertical GRF between the two shoe conditions. Compared to wearing low-MI shoes, wearing high-MI shoes showed that the maximum flexion angle of the knee, the contact area of patellofemoral joint and the peak knee extension moment reduced significantly (p < 0.01), and the peak patellofemoral contact force and stress decreased significantly (p < 0.05). Conclusion: These findings suggest that wearing high-MI shoes significantly decreases the patellofemoral contact force and patellofemoral joint stress by reducing the moment of knee extension, thus effectively reducing the load of the patellofemoral joint during the stance phase of running and potentially lowering the risk of PFPS.

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Section: Discussionsupporting

confidence: 43%

Patellofemoral Joint Loads during Running Immediately Changed by Shoes with Different Minimalist Indices: A Cross-sectional Study

et al. 2019

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“…This variance in outcome could be explained by the lower feedback dosage delivered by Esculier at al. (five ten minute sessions over 8 weeks) (Esculier et al, 2018), compared to both Roper et al (8 sessions over 2 weeks) (Roper et al, 2016) and Bonacci et al (10 sessions over 6 weeks) (Bonacci et al, 2018). It should also be noted that feedback targeting a specific movement deficit (high peak hip adduction and a rearfoot strike pattern respectively) was adopted in three comparable studies (Bonacci et al, 2018;Roper et al, 2016;Willy, Scholz, et al, 2012), whereas Esculier et al (Esculier et al, 2018) utilised a step rate cue that may not have been required by all participants within their cohort.…”

Section: Movement/run Retrainingmentioning

confidence: 91%

“…Roper et al (Roper et al, 2016) reported a significant short-term reduction in pain after external cueing to transition to a forefoot strike pattern, compared to load management control. In addition, Bonacci et al (Bonacci, Hall, Saunders, & Vicenzino, 2018) reported a significant short-term reduction in pain after external cueing to increase step rate to match a metronome beat, combined with the use of a minimalist shoe, in comparison to prefabricated foot orthoses. In contrast, Esculier et al (Esculier et al, 2018) evaluated the additional benefit of increasing step rate with the option of transitioning to a non-rearfoot strike pattern if the treating clinician deemed necessary, but reported no additional benefit of this running retraining protocol compared to load management education.…”

Section: Movement/run Retrainingmentioning

confidence: 99%

How to manage patellofemoral pain – Understanding the multifactorial nature and treatment options

Lack

Neal

Silva

et al. 2018

Physical Therapy in Sport

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Patellofemoral pain (PFP) is one of the most prevalent conditions within sports medicine, orthopaedic and general practice settings. Long-term treatment outcomes are poor, with estimates that more than 50% of people with the condition will report symptoms beyond 5 years following diagnosis. Additionally, emerging evidence indicates that PFP may be on a continuum with patellofemoral osteoarthritis. Consensus of world leading clinicians and academics highlights the potential benefit of delivering tailored interventions, specific to an individual's needs, to improve patient outcome. This clinical masterclass aims to develop the reader's understanding of PFP aetiology, inform clinical assessment and increase knowledge regarding individually tailored treatment approaches. It offers practical application guidance, and additional resources, that can positively impact clinical practice.

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“…Researchers transversely compared the biomechanical data between these two strike patterns [18] and the acute changes in their longitudinal posture to analyze their differences [19]. Moreover, most studies of gait retraining have targeted runners with patellofemoral pain [20], ignoring the different running patterns such as greater hip adduction and internal rotation between runners with patellofemoral pain and healthy runners [21]. Meanwhile, previous studies have reported that persons with patellofemoral pain may have an abnormal joint structure (i.e., patella malalignment and patella alta) that could influence joint contact mechanics [22].…”

Section: Introductionmentioning

confidence: 99%

Twelve-Week Gait Retraining Reduced Patellofemoral Joint Stress during Running in Male Recreational Runners

Wang

Yang

Zhang

et al. 2020

BioMed Research International

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Purpose. To explore the changes in knee sagittal angle and moment and patellofemoral joint (PFJ) force and stress before and after 12-week gait retraining. Methods. A total of 30 healthy male recreational runners were randomized into a control group (n=15) who ran in their original strike pattern using minimalist shoes or experimental group (n=15) who ran in a forefoot strike pattern using minimalist shoes during the 12-week gait retraining. The kinematic and kinetic data of the dominant leg of the participants during the 12 km/h running were collected by 3D motion capture systems and 3D force platforms. Besides, the biomechanical property of the PFJ was calculated on the basis of the joint force model and the regression equation of the contact area. Results. After the 12-week gait retraining, 78% of the rearfoot strikers turned into forefoot strikers. Peak knee extension moment and peak PFJ stress decreased by 13.8% and 13.3% without altering the running speed, respectively. Meanwhile, no changes in maximum knee flexion angle/extension moment and PFJ force/stress were observed for the control group. Conclusion. The 12-week gait retraining effectively reduced the PFJ stress, thereby providing a potential means of reducing the risk of patellofemoral pain syndrome while running.

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Gait retraining versus foot orthoses for patellofemoral pain: a pilot randomised clinical trial

Cited by 36 publications

References 28 publications

Patellofemoral Joint Loads during Running Immediately Changed by Shoes with Different Minimalist Indices: A Cross-sectional Study

Patellofemoral Joint Loads during Running Immediately Changed by Shoes with Different Minimalist Indices: A Cross-sectional Study

How to manage patellofemoral pain – Understanding the multifactorial nature and treatment options

Twelve-Week Gait Retraining Reduced Patellofemoral Joint Stress during Running in Male Recreational Runners

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