Strength, Flexibility and Postural Control of the Trunk and Lower Body in Participants with and without Patellofemoral Pain
Source abstract
Abstract
Patellofemoral pain (PFP) is a frequent knee condition. The aim of this study was to investigate strength, flexibility and postural control in people with and without PFP. Fifty-five participants between 14 and 54 years of age (PFP = 18, control group = 37) were included. Strength and flexibility for all trunk, hip, knee and ankle muscle groups were measured along with postural control outcomes. Analyses were conducted based on the “affected” and “non-affected” leg within-group and between-groups. Between-groups analysis demonstrated a statistically lower strength of trunk muscles (range: 35.8–29.3%, p < 0.001), knee extensors (20.8%, p = 0.005) and knee flexors (17.4%, p = 0.020) in PFP participants. Within-group analysis proved an 8.7% (p = 0.018) greater hip internal rotation strength and ankle extension flexibility (p = 0.032) of the “affected side” in PFP participants. This was, to our knowledge, the first study to investigate the strength of all trunk muscle groups. The results indicate that participants with PFP exhibit impaired strength of trunk muscle groups, along with knee muscle deficits, which may present a rehabilitation target. Clinicians should consider implementing trunk strengthening exercises into PFP programs along with knee-targeting exercise programs.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Lower Extremity Biomechanics and Pathologies · Foot and Ankle Surgery · Occupational Health and Performance
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Department of Physical Therapy, Faculty of Health Sciences, University of Primorska, Polje 42, 6310 Izola, Slovenia
Clinical Institute of Occupational, Traffic and Sports Medicine, University Medical Centre Ljubljana, Zaloška Cesta 7, 1000 Ljubljana, Slovenia
Department of Kinesiology, Faculty of Sport, University of Ljubljana, Gortanova Ulica 22, 1000 Ljubljana, Slovenia
Laboratory for Motor Control and Motor Behavior, Science to Practice, Ltd., S2P, Tehnološki Park 19, 1000 Ljubljana, Slovenia
References (54)
Show source-provided references
1. Incidence and prevalence of patellofemoral pain: A systematic review and meta-analysis10.1371/journal.pone.0190892 ↗
2. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures10.1136/bjsports-2016-096384 ↗
3. Risk factors for patellofemoral pain syndrome: A systematic review10.2519/jospt.2012.3803 ↗
4. Individuals with patellofemoral pain exhibit greater patellofemoral joint stress: A finite element analysis study10.1016/j.joca.2010.12.001 ↗
5. Patellofemoral stress during walking in persons with and without patellofemoral pain10.1097/00005768-200210000-00009 ↗
6. A comparison of hip strength between sedentary females with and without patellofemoral pain syndrome10.2519/jospt.2010.3120 ↗
7. Trunk biomechanics and its association with hip and knee kinematics in patients with and without patellofemoral pain10.1016/j.math.2014.08.013 ↗
8. Hip Strength in Females with and without Patellofemoral Pain10.2519/jospt.2003.33.11.671 ↗
9. Plantar loading characteristics during walking in females with and without patellofemoral pain10.7547/8750-7315-105.1.1 ↗
10. Core stability measures as risk factors for lower extremity injury in athletes10.1249/01.MSS.0000128145.75199.C3 ↗
11. Impairments of postural stability, core endurance, fall index and functional mobility skills in patients with patello femoral pain syndrome10.3233/BMR-160729 ↗
12. The influence of abnormal hip mechanics on knee injury: A biomechanical perspective10.2519/jospt.2010.3337 ↗
13. Altered hip and trunk muscle function in individuals with patellofemoral pain10.1136/bjsm.2008.053553 ↗
14. Relationship between frontal plane projection angle of the knee and hip and trunk strength in women with and without patellofemoral pain10.3233/BMR-150622 ↗
15. Evidence-based framework for a pathomechanical model of patellofemoral pain: 2017 patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester, UK: Part 310.1136/bjsports-2017-098717 ↗
16. Barton, C.J., Lack, S., Hemmings, S., Tufail, S., and Morrissey, D. (2015). The “Best Practice Guide to Conservative Management of Patellofemoral Pain”: Incorporating level 1 evidence with expert clinical reasoning. Br. J. Sports Med., 923–934.10.1136/bjsports-2014-093637 ↗
17. A prospective investigation of biomechanical risk factors for patellofemoral pain syndrome. The joint undertaking to monitor and prevent ACL injury (JUMP-ACL) cohort10.1177/0363546509337934 ↗
18. Foot and ankle characteristics in patellofemoral pain syndrome: A case control and reliability study10.2519/jospt.2010.3227 ↗
19. Comparison of isometric ankle strength between females with and without patellofemoral pain syndrome
20. Gender-Specific Risk Factor Profiles for Patellofemoral Pain10.1097/JSM.0000000000000719 ↗
21. Kinematic and electromyographic analysis in patients with patellofemoral pain syndrome during single leg triple hop test10.1016/j.gaitpost.2016.07.020 ↗
22. Risk factors for patellofemoral pain: A systematic review and meta-analysis10.1136/bjsports-2017-098890 ↗
23. Rathleff, C.R., Neill Baird, W., Olesen, J.L., Roos, E.M., Rasmussen, S., and Rathleff, M.S. (2013). Hip and Knee Strength Is Not Affected in 12–16 Year Old Adolescents with Patellofemoral Pain-A Cross-Sectional Population-Based Study. PLoS ONE, 8.10.1371/journal.pone.0079153 ↗
24. Difference in leg asymmetry between female collegiate athletes and recreational athletes during drop vertical jump10.1186/s13018-019-1490-5 ↗
25. Hip strengthening prior to functional exercises reduces pain sooner than quadriceps strengthening in females with patellofemoral pain syndrome: A randomized clinical trial10.2519/jospt.2011.3499 ↗
26. Syndrome De Wiedemann-Beckwith Infantile, Avec Hypoglycemie Maternelle Severe, Steatose Hepatique Aigue Gravidique Et Syndrome De Sheehan
27. Trunk, pelvis, hip, and knee kinematics, hip strength, and gluteal muscle activation during a single-leg squat in males and females with and without patellofemoral pain syndrome10.2519/jospt.2012.3987 ↗
28. Association of navicular drop and selected lower-limb biomechanical measures during the stance phase of running10.1123/jab.2011-0162 ↗
29. Prevalence of flexible flat foot in adults: A cross-sectional study
30. Patella Alta: A Comprehensive Review of Current Knowledge
31. Closed Kinetic Chain exercises with or without additional hip strengthening exercises in management of Patellofemoral pain syndrome: A randomized controlled trial
32. The Effect of Fatigue on Single-Leg Postural Sway and Its Transient Characteristics in Healthy Young Adults10.3389/fphys.2021.720905 ↗
33. Kozinc, Ž., Smajla, D., and Šarabon, N. (2020). Relationship between hip abductor strength, rate of torque development scaling factor and medio-lateral stability in older adults. Gait Posture, in press.
34. Advancements in the Protocol for Rate of Force Development/Relaxation Scaling Factor Evaluation10.3389/fnhum.2021.654443 ↗
35. Rate of force development: Physiological and methodological considerations10.1007/s00421-016-3346-6 ↗
36. Meyer, C., Corten, K., Wesseling, M., Peers, K., Simon, J.-P., Jonkers, I., and Desloovere, K. (2013). Test-Retest Reliability of Innovated Strength Tests for Hip Muscles. PLoS ONE, 8.10.1371/journal.pone.0081149 ↗
37. Hip and trunk muscles activity during nordic hamstring exercise10.12965//jer.1835200.600 ↗
38. Concurrent validity of digital inclinometer and universal goniometer in assessing passive hip mobility in healthy subjects
39. Intra- And inter-rater reliability of joint range of motion tests using tape measure, digital inclinometer and inertial motion capturing10.1371/journal.pone.0243646 ↗
40. Relationship between ankle strength and range of motion and postural stability during single-leg quiet stance in trained athletes10.1038/s41598-021-91337-6 ↗
41. Norkin, C., and White, J. (2016). Measurement of Joint Motion: A Guide to Goniometry, F.A. Davis.
42. Inter-limb asymmetries in volleyball players: Differences between testing approaches and association with performance
43. User’s guide to correlation coefficients10.1016/j.tjem.2018.08.001 ↗
44. Bernards, J., Sato, K., Haff, G., and Bazyler, C. (2017). Current Research and Statistical Practices in Sport Science and a Need for Change. Sports, 5.10.3390/sports5040087 ↗
45. Lower extremity jumping mechanics of female athletes with and without patellofemoral pain before and after exertion10.1177/0363546508315592 ↗
46. Frontal plane biomechanics in males and females with and without patellofemoral pain10.1249/MSS.0b013e318256903a ↗
47. Sagittal Plane Trunk Posture Influences Patellofemoral Joint Stress during Running10.2519/jospt.2014.5249 ↗
48. Adding motor control training to muscle strengthening did not substantially improve the effects on clinical or kinematic outcomes in women with patellofemoral pain: A randomised controlled trial10.1016/j.gaitpost.2017.08.018 ↗
49. Pain, Function, and Strength Outcomes for Males and Females with Patellofemoral Pain Who Participate in Either a Hip/Core- or Knee-Based Rehabilitation Program
50. The Effect of Valgus Control Instruction Exercises on Pain, Strength, and Functionality in Active Females with Patellofemoral Pain Syndrome10.1177/1941738119837622 ↗
51. Best Practice & Research Clinical Rheumatology Rethinking patellofemoral pain: Prevention, management and long-term consequences10.1016/j.berh.2019.02.004 ↗
52. Factors associated with patellofemoral pain syndrome: A systematic review10.1136/bjsports-2011-090369 ↗
53. Analysis of pain, functional capacity, muscular strength and balance in young women with Patellofemoral Pain Syndrome10.1590/1980-5918.030.003.ao01 ↗
54. The influence of hip abductor muscle performance on dynamic postural stability in females with patellofemoral pain10.1016/j.gaitpost.2012.03.024 ↗