PDF herunterladen
Int J Sports Med 2013; 34(11): 997-1002
DOI: 10.1055/s-0033-1334966
Orthopedics & Biomechanics
© Georg Thieme Verlag KG Stuttgart · New York

Hip and Knee Kinematics are Associated with Pain and Self-reported Functional Status in Males and Females with Patellofemoral Pain

T. H. Nakagawa
1   Physical Therapy, Federal University of São Carlos, Brazil
,
F. V. Serrão
1   Physical Therapy, Federal University of São Carlos, Brazil
,
C. D. Maciel
2   Electrical Engineering, University of São Paulo, Brazil
,
C. M. Powers
3   Jacquelin Perry Musculoskeletal Biomechanics Research Laboratory, University of Southern California, Los Angeles, United States
› Institutsangaben
Weitere Informationen

Publikationsverlauf



accepted after revision 04. Februar 2013

Publikationsdatum:
14. Juni 2013 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Abstract

Altered hip and knee kinematics in the frontal and transverse planes may increase patellofemoral joint stress and contribute to the development of patellofemoral pain. The purpose of this cross-sectional study was to evaluate the association among hip and knee kinematics, pain, and self-reported functional status in males and females with patellofemoral pain. 20 males and 20 females with patellofemoral pain participated in this study. 3-dimensional hip and knee kinematics were quantified while performing a step-down task. A visual analogue scale was used to evaluate usual knee pain. The anterior knee pain scale was used to evaluate the knee functional score. For both groups combined, greater usual pain was associated with greater peak hip adduction, hip internal rotation and knee abduction (r=0.54–0.57, P<0.001). Also, modest to low correlations (r=−0.48 to − 0.37, P=0.03–0.08) were found among hip and knee kinematics and functional score. Stepwise regression revealed that peak hip internal rotation and hip adduction were significant predictors of pain, while peak hip adduction was the only predictor of function. Greater hip adduction, hip internal rotation and knee abduction are associated with higher levels of pain and reduced function in males and females with patellofemoral pain.

Key words

anterior knee pain - patella - biomechanics
 

  • References

  • 1 Baldon Rde M, Nakagawa TH, Muniz TB, Amorim CF, Maciel CD, Serrao FV. Eccentric hip muscle function in females with and without patellofemoral pain syndrome. J Athl Train 2009; 44: 490-496
    CrossrefPubMedSuche in Google Scholar
  • 2 Baquie P, Brukner P. Injuries presenting to an Australian sports medicine centre: a 12-month study. Clin J Sport Med 1997; 7: 28-31
    CrossrefPubMedSuche in Google Scholar
  • 3 Barton CJ, Levinger P, Webster KE, Menz HB. Walking kinematics in individuals with patellofemoral pain syndrome: a case-control study. Gait Posture 2011; 33: 286-291
    CrossrefPubMedSuche in Google Scholar
  • 4 Besier TF, Gold GE, Delp SL, Fredericson M, Beaupre GS. The influence of femoral internal and external rotation on cartilage stresses within the patellofemoral joint. J Orthop Res 2008; 26: 1627-1635
    CrossrefPubMedSuche in Google Scholar
  • 5 Boling MC, Padua DA, Marshall SW, Guskiewicz K, Pyne S, Beutler A. A prospective investigation of biomechanical risk factors for patellofemoral pain syndrome: the Joint Undertaking to Monitor and Prevent ACL Injury (JUMP-ACL) cohort. Am J Sports Med 2009; 37: 2108-2116
    CrossrefPubMedSuche in Google Scholar
  • 6 Brechter JH, Powers CM. Patellofemoral joint stress during stair ascent and descent in persons with and without patellofemoral pain. Gait Posture 2002; 16: 115-123
    CrossrefPubMedSuche in Google Scholar
  • 7 Crossley KM, Bennell KL, Cowan SM, Green S. Analysis of outcome measures for persons with patellofemoral pain: which are reliable and valid?. Arch Phys Med Rehabil 2004; 85: 815-822
    CrossrefPubMedSuche in Google Scholar
  • 8 Devereaux MD, Lachmann SM. Patello-femoral arthralgia in athletes attending a Sports Injury Clinic. Br J Sports Med 1984; 18: 18-21
    CrossrefPubMedSuche in Google Scholar
  • 9 Dierks TA, Manal KT, Hamill J, Davis IS. Proximal and distal influences on hip and knee kinematics in runners with patellofemoral pain during a prolonged run. J Orthop Sports Phys Ther 2008; 38: 448-456
    CrossrefPubMedSuche in Google Scholar
  • 10 Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng 1983; 105: 136-144
    CrossrefPubMedSuche in Google Scholar
  • 11 Harriss DJ, Atkinson G. Update – Ethical standards in sport and exercise science research. Int J Sports Med 2011; 32: 819-821
    Thieme ConnectPubMedSuche in Google Scholar
  • 12 Huberti HH, Hayes WC. Patellofemoral contact pressures. The influence of q-angle and tendofemoral contact. J Bone Joint Surg Am 1984; 66: 715-724
    PubMedSuche in Google Scholar
  • 13 Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O. Scoring of patellofemoral disorders. Arthroscopy 1993; 9: 159-163
    CrossrefPubMedSuche in Google Scholar
  • 14 Leardini A, Cappozzo A, Catani F, Toksvig-Larsen S, Petitto A, Sforza V, Cassanelli G, Giannini S. Validation of a functional method for the estimation of hip joint centre location. J Biomech 1999; 32: 99-103
    CrossrefPubMedSuche in Google Scholar
  • 15 Lee TQ, Anzel SH, Bennett KA, Pang D, Kim WC. The influence of fixed rotational deformities of the femur on the patellofemoral contact pressures in human cadaver knees. Clin Orthop Relat Res 1994; 69-74
    PubMedSuche in Google Scholar
  • 16 Leetun DT, Ireland ML, Willson JD, Ballantyne BT, Davis IM. Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc 2004; 36: 926-934
    CrossrefPubMedSuche in Google Scholar
  • 17 Long-Rossi F, Salsich GB. Pain and hip lateral rotator muscle strength contribute to functional status in females with patellofemoral pain. Physiother Res Int 2010; 15: 57-64
    PubMedSuche in Google Scholar
  • 18 Magalhães E, Fukuda TY, Sacramento SN, Forgas A, Cohen M, Abdalla RJ. A comparison of hip strength between sedentary females with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther 2010; 40: 641-647
    CrossrefPubMedSuche in Google Scholar
  • 19 Mascal CL, Landel R, Powers C. Management of patellofemoral pain targeting hip, pelvis, and trunk muscle function: 2 case reports. J Orthop Sports Phys Ther 2003; 33: 647-660
    CrossrefPubMedSuche in Google Scholar
  • 20 McKenzie K, Galea V, Wessel J, Pierrynowski M. Lower extremity kinematics of females with patellofemoral pain syndrome while stair stepping. J Orthop Sports Phys Ther 2010; 40: 625-632
    CrossrefPubMedSuche in Google Scholar
  • 21 Myer GD, Ford KR, Barber Foss KD, Goodman A, Ceasar A, Rauh MJ, Divine JG, Hewett TE. The incidence and potential pathomechanics of patellofemoral pain in female athletes. Clin Biomech (Bristol, Avon) 2010; 25: 700-707
    CrossrefPubMedSuche in Google Scholar
  • 22 Nakagawa TH, Baldon Rde M, Muniz TB, Serrao FV. Relationship among eccentric hip and knee torques, symptom severity and functional capacity in females with patellofemoral pain syndrome. Phys Ther Sport 2011; 12: 133-139
    CrossrefPubMedSuche in Google Scholar
  • 23 Nakagawa TH, Moriya ET, Maciel CD, Serrao FV. 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 syndrome. J Orthop Sports Phys Ther 2012; 42: 491-501
    CrossrefPubMedSuche in Google Scholar
  • 24 Nguyen AD, Shultz SJ, Schmitz RJ, Luecht RM, Perrin DH. A preliminary multifactorial approach describing the relationships among lower extremity alignment, hip muscle activation, and lower extremity joint excursion. J Athl Train 2011; 46: 246-256
    PubMedSuche in Google Scholar
  • 25 Noehren B, Pohl MB, Sanchez Z, Cunningham T, Lattermann C. Proximal and distal kinematics in female runners with patellofemoral pain. Clin Biomech (Bristol, Avon) 2012; 27: 366-371
    CrossrefPubMedSuche in Google Scholar
  • 26 Noehren B, Scholz J, Davis I. The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome. Br J Sports Med 2011; 45: 691-696
    CrossrefPubMedSuche in Google Scholar
  • 27 Piva SR, Fitzgerald GK, Irrgang JJ, Kirtley C, Leardini A, Rosenbaum D, Whittle M, D’Lima DD, Cristofolini L, Witte H, Schmid O, Stokes I. Associates of physical function and pain in patients with patellofemoral pain syndrome. Arch Phys Med Rehabil 2009; 90: 285-295
    CrossrefPubMedSuche in Google Scholar
  • 28 Powers CM. The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther 2010; 40: 42-51
    CrossrefPubMedSuche in Google Scholar
  • 29 Powers CM. The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther 2003; 33: 639-646
    CrossrefPubMedSuche in Google Scholar
  • 30 Powers CM, Ward SR, Fredericson M, Guillet M, Shellock FG. Patellofemoral kinematics during weight-bearing and non-weight-bearing knee extension in persons with lateral subluxation of the patella: a preliminary study. J Orthop Sports Phys Ther 2003; 33: 677-685
    CrossrefPubMedSuche in Google Scholar
  • 31 Prins MR, van der Wurff P. Females with patellofemoral pain syndrome have weak hip muscles: a systematic review. Aust J Physiother 2009; 55: 9-15
    CrossrefPubMedSuche in Google Scholar
  • 32 Salsich GB, Long-Rossi F. Do females with patellofemoral pain have abnormal hip and knee kinematics during gait?. Physiother Theory Pract 2010; 26: 150-159
    CrossrefPubMedSuche in Google Scholar
  • 33 Salsich GB, Perman WH. Patellofemoral joint contact area is influenced by tibiofemoral rotation alignment in individuals who have patellofemoral pain. J Orthop Sports Phys Ther 2007; 37: 521-528
    CrossrefPubMedSuche in Google Scholar
  • 34 Souza RB, Draper CE, Fredericson M, Powers CM. Femur rotation and patellofemoral joint kinematics: a weight-bearing magnetic resonance imaging analysis. J Orthop Sports Phys Ther 2010; 40: 277-285
    CrossrefPubMedSuche in Google Scholar
  • 35 Souza RB, Powers CM. Differences in hip kinematics, muscle strength, and muscle activation between subjects with and without patellofemoral pain. J Orthop Sports Phys Ther 2009; 39: 12-19
    CrossrefPubMedSuche in Google Scholar
  • 36 Souza RB, Powers CM. Predictors of hip internal rotation during running: an evaluation of hip strength and femoral structure in women with and without patellofemoral pain. Am J Sports Med 2009; 37: 579-587
    CrossrefPubMedSuche in Google Scholar
  • 37 Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med 2002; 36: 95-101
    CrossrefPubMedSuche in Google Scholar
  • 38 Watson CJ, Propps M, Ratner J, Zeigler DL, Horton P, Smith SS. Reliability and responsiveness of the lower extremity functional scale and the anterior knee pain scale in patients with anterior knee pain. J Orthop Sports Phys Ther 2005; 35: 136-146
    CrossrefPubMedSuche in Google Scholar
  • 39 Willson JD, Davis IS. Lower extremity mechanics of females with and without patellofemoral pain across activities with progressively greater task demands. Clin Biomech (Bristol, Avon) 2008; 23: 203-211
    CrossrefPubMedSuche in Google Scholar
  • 40 Willson JD, Kernozek TW, Arndt RL, Reznichek DA, Scott Straker J. Gluteal muscle activation during running in females with and without patellofemoral pain syndrome. Clin Biomech (Bristol, Avon) 2011; 26: 735-740
    CrossrefPubMedSuche in Google Scholar
  • 41 Willson JD, Petrowitz I, Butler RJ, Kernozek TW. Male and female gluteal muscle activity and lower extremity kinematics during running. Clin Biomech (Bristol, Avon). 2012
    PubMedSuche in Google Scholar
  • 42 Witvrouw E, Lysens R, Bellemans J, Cambier D, Vanderstraeten G. Intrinsic risk factors for the development of anterior knee pain in an athletic population. A two-year prospective study. Am J Sports Med 2000; 28: 480-489
    CrossrefPubMedSuche in Google Scholar
  • 43 Wu G, Siegler S, Allard P, Fritz JM, Wisniewski S, McGinty GT, Childs JD, Domenech MA, Jones S, Delitto A. ISB recommendation on definitions of joint coordinate system of various joints for the reporting of human joint motion – part I: ankle, hip, and spine. International Society of Biomechanics. J Biomech 2002; 35: 543-548
    CrossrefPubMedSuche in Google Scholar