Lower Amplitude of the Hoffmann Reflex in Women With Patellofemoral Pain: Thinking Beyond Proximal, Local, and Distal Factors

Silva, Danilo de Oliveira; Magalhães, Fernando Henrique; Faria, Natália; Pazzinatto, Marcella Ferraz; Ferrari, Déborah Viviane; Pappas, Evangelos; Azevedo, Fábio Mícolis de

doi:10.1016/j.apmr.2015.12.017

Cited by 24 publications

(34 citation statements)

References 40 publications

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“…The parameter extracted from the electromyographic data was the median frequency (Fmed) of the vastus medialis (VM) and vastus lateralis (VL), a commonly used parameter in the study of neuromuscular fatigue 24 , 25 in two muscles highly related with this disorder. 26 Data collection and processing were done according to previous literature. 24 , 25 As shown in Table 1 , no differences were found in the VM or VL for either the control groups or the PFP groups.…”

Section: Methodsmentioning

confidence: 99%

Different pain responses to distinct levels of physical activity in women with patellofemoral pain

Briani

Pazzinatto

Silva

et al. 2017

Brazilian Journal of Physical Therapy

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Section: Methodsmentioning

confidence: 99%

Different pain responses to distinct levels of physical activity in women with patellofemoral pain

Briani

Pazzinatto

Silva

et al. 2017

Brazilian Journal of Physical Therapy

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“…Møller et al[ 17 ] found a 20% decrease in the VM and VL EMG activity during MVIC as compared to nonsymptomatic knees, which is in line with our findings of 30% of decrease. These findings may be interpreted in light of recent studies that reported lower excitability of the monosynaptic reflex pathway of the VM muscle in women with PFP as compared to controls [ 45 ], which is related with pain, function and chronicity [ 46 ]. As shown by Park and Hopkins [ 47 ], both voluntary and involuntary inhibitory pathways may be involved in such a reduced motoneuronal excitability, and hence women with PFP may not be able to recruit the entire pool of motoneurons during maximum quadriceps efforts, which may be related to inhibitory neural mechanisms [ 45 , 46 ].…”

Section: Discussionmentioning

confidence: 58%

Quadriceps neuromuscular function in women with patellofemoral pain: Influences of the type of the task and the level of pain

Briani¹,

Silva²,

Flóride³

et al. 2018

PLoS ONE

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The present study aimed at investigating whether the neuromuscular system behaves differently (in terms of force and muscle activity generation) as a function of the task being performed (i.e. maximal voluntary efforts vs stair negotiation) and the presence of patellofemoral pain (PFP) and possible influences of pain intensity. Thirty-eight women with (n = 19) and without PFP (n = 19) had their knee strength (extension joint torque) measured during maximal voluntary isometric contractions (MVIC) and electromyography (EMG) data recorded during both MVIC and stair ascent tasks, which were performed before and after a loading protocol designed to exacerbate pain symptoms. Women with PFP displayed lower levels of vastus medialis (p = 0.002) and vastus lateralis (p = 0.032) EMG activation during MVIC assessments. Conversely, the PFP group showed higher levels of vastus medialis muscle activity during stair climbing (p = 0.007), which happened exclusively after the loading protocol. Similarly, women with PFP displayed lower knee extensor torque only during the MVIC tests performed after the loading protocol, which was moderately correlated with the increase in self-reported pain (p = 0.041, r = 0.37), whereas the changes in EMG activity during stair ascent were not correlated with changes in pain intensity (p = 0.215, r = 0.12). These results suggest that, in comparison to pain-free controls, women with PFP display lower levels of quadriceps EMG activation during maximal contractions, but higher activation during dynamic tasks (stair ascent). In addition, the moderate association between the decrease in knee extensor torque and increase in self-reported pain indicates that care should be taken by clinicians during quadriceps strength evaluation in women with PFP, as misleading outcomes may emerge if the intensity of knee pain is not considered during screening. Additionally, rehabilitation strategies should focus on both restoring neuromuscular control and increasing muscle strength.

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“…Diagnosis of PFP was confirmed following consensus from two experienced clinicians (N5 years' experience) and based on definitions used in previous studies [18][19][20]. The inclusion criteria were: (1) anterior knee pain during at least two of the following activities: prolonged sitting, squatting, kneeling, running, climbing stairs, and jumping; (2) pain during patellar palpation;…”

Section: Participantsmentioning

confidence: 99%

Association between increase in vertical ground reaction force loading rate and pain level in women with patellofemoral pain after a patellofemoral joint loading protocol

et al. 2018

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Lower Amplitude of the Hoffmann Reflex in Women With Patellofemoral Pain: Thinking Beyond Proximal, Local, and Distal Factors

Cited by 24 publications

References 40 publications

Different pain responses to distinct levels of physical activity in women with patellofemoral pain

Different pain responses to distinct levels of physical activity in women with patellofemoral pain

Quadriceps neuromuscular function in women with patellofemoral pain: Influences of the type of the task and the level of pain

Association between increase in vertical ground reaction force loading rate and pain level in women with patellofemoral pain after a patellofemoral joint loading protocol

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