Kinematic and kinetic features of normal level walking in patellofemoral pain syndrome: More than a sagittal plane alteration |
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| Authors: | Marco Paoloni Massimiliano Mangone Giancarlo Fratocchi Massimiliano Murgia Vincenzo Maria Saraceni Valter Santilli |
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| Institution: | 1. Department of Physical Therapy, State University of West Parana, Research Laboratory of Human Movement, Cascavel, PR, Brazil;2. Department of Physical Therapy, University of São Paulo State, School of Science and Technology, Laboratory of Biomechanics and Motor Control, Presidente Prudente, SP, Brazil;3. University of São Paulo, Post-graduation Program Interunits Bioengineering, EESC/FMRP/IQSC-USP, São Carlos, Brazil;1. Biomechanics Laboratory, Sport Science Institute, Korea National Sport University, Seoul, Republic of Korea;2. Faculties of Kinesiology, University of Calgary, Calgary, Alberta, Canada;3. Faculties of Nursing, University of Calgary, Calgary, Alberta, Canada;4. Running Injury Clinic, Calgary, Alberta, Canada;1. Functional and Applied Biomechanics, Department of Rehabilitation Medicine, NIH, Bethesda, MD, USA;2. Physical Therapy and Rehabilitation Science, University of Maryland, College Park, MD, USA;3. Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA |
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| Abstract: | Patients with patellofemoral pain syndrome (PFPS) often report discomfort and pain during walking. To date, most of the studies conducted to determine gait alterations in PFPS patients have focused on sagittal plane alterations. Physiological and biomechanical factors, however, suggest that frontal and transverse plane alterations may be involved in PFPS. We therefore decided to conduct a kinematic and kinetic evaluation on all three planes in 9 PFPS subjects and 9 healthy sex- and age-matched controls. General gait characteristics were similar in patients and controls, with the exception of swing velocity, which was lower in PFPS patients. Patients also displayed an increased knee abductor and external rotator moments in loading response, and reduced knee extensor moment both in loading response and in terminal stance. We speculate that these findings may be linked both to a pain-avoiding gait pattern and to alterations in the timing of activation of different components of the quadriceps muscle, which is typical of PFPS. The relevance for clinicians is this gait pattern may represent a biomechanical risk factor for future knee osteoarthritis. We therefore recommend that treatments aimed at PFPS should also attempt to restore a correct walking pattern. |
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