Aspects of muscular function in women with patellofemoral pain and its implications for movement pattern during stair ascent

Author(s)

Amanda Schenatto Ferreira

• Document type: Master's Dissertation
• Press: Presidente Prudente. 2018-06-05.
• Institution: Universidade Estadual Paulista (Unesp). Faculdade de Ciências e Tecnologia. Presidente Prudente
• Defense date: 2018-05-11
• Advisor: Fábio Mícolis de Azevedo

Abstract

Patellofemoral pain is more likely to affect women. Pain is exacerbated by activities that load the patellofemoral joint during weight bearing on a flexed knee, such as stair ascent. Despite the source of pain remains unclear, multiple factors have been proposed to explain the development of PFP, especially the impairment in knee and hip maximal strength. However, unfavorable recovery has been reported even after treatments focused on quadriceps and hip strengthening. Thus, other aspects of muscular function are possibly being neglected and should be better explored in PFP, such as force steadiness and rate of force development (muscle power). Therefore, the aims of this dissertation were to compare force steadiness, rate of force development and maximal strength of the knee extensors and hip abductors between women with PFP and pain-free controls and to investigate the influence of hip muscle strength and rearfoot kinematics on the movement pattern during stair ascent in women with PFP. Strength parameters were assessed using an isokinetic dynamometer. Kinematic analysis was performed during stair ascent tasks in an experimental set up composed by 9 cameras for acquisition of hip and rearfoot eversion joint angles. Women with PFP presented deficits in force steadiness, rate of force development and maximal strength of knee extensors and hip abductors compared with pain-free controls. Also, hip abductor strength explained significantly the variance of peak hip internal rotation during stair ascent in all women with PFP. These findings highlight that important components of muscle function have been neglected in PFP literature and should be considered during assessment of women with PFP. Therefore, evidence-based treatments aiming at improving force steadiness and muscle power may be a promising addition to the usual protocols of knee and hip strengthening for PFP management. (AU)

• FAPESP's process: 16/02357-1 - Analysis of the hip torque and kinematics of the femur and rearfoot considering the ascending and descending theories as causal factors of patellofemoral pain
• Grantee: Amanda Schenatto Ferreira
• Support Opportunities: Scholarships in Brazil - Master