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The influence of knee crepitus on quadriceps avoidance parameters in women with patellofemoral pain

Grant number: 19/03214-8
Support Opportunities:Scholarships abroad - Research Internship - Master's degree
Effective date (Start): July 21, 2019
Effective date (End): December 20, 2019
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Fábio Mícolis de Azevedo
Grantee:Marina Cabral Waiteman
Supervisor: David Matthew Bazett-Jones
Host Institution: Faculdade de Ciências e Tecnologia (FCT). Universidade Estadual Paulista (UNESP). Campus de Presidente Prudente. Presidente Prudente , SP, Brazil
Research place: University of Toledo (UT), United States  
Associated to the scholarship:18/07542-7 - Investigation about neurophysiological alterations in women with patellofemoral pain: association with performance in clinical tests and knee joint moment during functional tasks, BP.MS


Patellofemoral pain (PFP) is a common knee disorder of insidious onset. Knee crepitus is a common clinical sign in individuals with PFP, presenting a prevalence of up to 70% in this population. Although knee crepitus does not seem to be related with poor clinical outcomes in women with PFP, it does seem to generate negative patients' beliefs over the condition. Interestingly, protection mechanisms such as quadriceps avoidance have been also found in individuals with PFP. However, although knee crepitus can negatively affect patient's beliefs, no study has investigated the relationship between knee crepitus with altered movement pattern, specifically quadriceps avoidance in individuals with PFP. The aim of this project is to compare the knee extensor moment, knee flexion angle, amplitude of the electromyography (EMG) activity of Vastus Medialis (VM) and Vastus Lateralis (VL) and co-contraction of quadriceps and hamstrings during a step-down task in women with PFP presenting and not presenting knee crepitus. Women with PFP aged 18 to 35 years will be recruited in Toledo - Ohio. An assessor will perform the knee crepitus test and participants will be asked to perform a step-down task. Kinematic and kinetic data during the step-down task will be obtained by a 3-D motion analysis system through an experimental set up with 9 infrared cameras and one force plate. The variables of interest will be peak knee extensor moment, peak knee flexion, mean amplitude of EMG activity of VM and VL and a co-contraction ratio of quadriceps and hamstrings. Statistical analysis will be performed to investigate between groups differences (independent t test or Mann-Whitney test). (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
WAITEMAN, MARINA CABRAL; SILVA, DANILO DE OLIVEIRA; AZEVEDO, FABIO M.; PAZZINATTO, MARCELLA F.; BRIANI, V, RONALDO; BAZETT-JONES, DAVID M.. Women with patellofemoral pain and knee crepitus have reduced knee flexion angle during stair ascent. PHYSICAL THERAPY IN SPORT, v. 48, p. 60-66, . (19/03214-8)

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