Proximal mechanics during stair ascent are more discriminate of females with patellofemoral pain than distal mechanics

Autor(es)

Silva, Danilo de Oliveira ^[1] ; Barton, Christian John ^{[2, 3]} ; Pazzinatto, Marcella Ferraz ^[1] ; Briani, Ronaldo Valdir ^[1] ; de Azevedo, Fabio Micolis ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo State, Sch Sci & Technol, Phys Therapy Dept, Presidente Prudente - Brazil

^[2] La Trobe Univ, Lower Extrem Gait Studies, Bundoora, Vic 3086 - Australia

^[3] Queen Mary Univ London, Ctr Sports & Exercise Med, London - England

• Tipo de documento: Artigo Científico
• Fonte: CLINICAL BIOMECHANICS; v. 35, p. 56-61, JUN 2016.
• Citações Web of Science: 15

Resumo

Background: Several hypotheses have been proposed to explain the pathomechanisms underlying patellofemoral pain (PFP). Concurrent evaluation of lower limb mechanics in the same PFP population is needed to determine which may be more important to target during rehabilitation. This study aimed to investigate possible differences in rearfoot eversion, hip adduction, and knee flexion during stair ascent; the relationship between these variables; and the discriminatory capability of each in identifying females with PFP. Method: Thirty-six females with PFP and 31 asymptomatic controls underwent three-dimensional kinematic analyses during stair ascent. Between-group comparisons were made for peak rearfoot eversion, hip adduction, and knee flexion. Pearson's correlation coefficients were calculated to evaluate relationships among these parameters. Receiver operating characteristic curves were applied to identify the discriminatory capability of each. Findings: Females with PFP ascended stairs with reduced peak knee flexion, greater peak hip adduction and peak rearfoot eversion. Peak hip adduction (>10.6 degrees; sensitivity = 67%, specificity = 77%) discriminated females with PFP more effectively than rearfoot eversion (>5.0 degrees; sensitivity = 58%, specificity = 67%). Reduced peak hip adduction was found to be associated with reduced peak knee flexion (r = 0.54, p = 0.002) in females with PFP. Interpretation: These findings indicate that proximal, local, and distal kinematics should be considered in PFP management, but proximally targeted interventions may be most important. The relationship of reduced knee flexion with reduced hip adduction also indicates a possible compensatory strategy to reduce patellofemoral joint stress, and this may need to be addressed during rehabilitation. (C) 2016 Elsevier Ltd. All rights reserved. (AU)

• Processo FAPESP: 14/24939-7 - Análise integrada de parâmetros biomecânicos para diagnóstico e classificação de mulheres com síndrome da dor femoropatelar: estudo de reprodutibilidade, precisão, acurácia diagnóstica e associação com dor e função
• Beneficiário: Fábio Mícolis de Azevedo
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 15/11534-1 - Influência da dor na análise de parâmetros cinemáticos das regiões proximais, locais e distais ao joelho em mulheres com dor femoropatelar durante subida e descida de escada
• Beneficiário: Danilo de Oliveira Silva
• Modalidade de apoio: Bolsas no Brasil - Doutorado