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Rearfoot and knee coupling over a prolonged run in runners with patellofemoral pain syndrome

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Patellofemoral pain syndrome (PFPS) is common in runners and is often related to excessive rearfoot eversion... Increased eversion is known to be associated with increased knee flexion, internal rotation, and reduced adduction... We also expected that these angles would increase to a greater degree in the PFPS group at the end of a prolonged run. 20 runners (18–40 yrs) with PFPS and 20 controls (CON) participated in a prolonged treadmill run averaging 30–45 min... A vector coding method was used to assess the following joint couplings: rearfoot eversion (EV) with knee flexion (KF), adduction (KADD), and internal rotation (KIR)... During period 1, all coupling values were unexpectedly lower in the PFPS group, with EV-KADD and EV-KIR couplings being significantly lower (Figure 1)... This relatively reduced eversion may have been a compensatory control strategy to minimize the abnormal knee mechanics that often accompany excessive eversion... By period 2, coupling angles were similar between the 2 groups for all relationships... As this is the period of maximal loading, the PFPS group may not have been able to maintain the relatively reduced EV seen in early loading... Over the course of the run, both groups increased their coupling angles in period 1 at the end of the prolonged run compared to the beginning... During maximal loading, coupling is generally similar between groups... Finally, both groups increased their coupling angles over the course of the prolonged run.

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Coupling angle group means during the 2 loading periods of stance at the beginning and end of the run. * = Significant main effect for group in a period. ** = Significant main effect for time in a period. Horizontal dashed line at 45° indicates point of equal amounts of EV and knee excursion.
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Figure 1: Coupling angle group means during the 2 loading periods of stance at the beginning and end of the run. * = Significant main effect for group in a period. ** = Significant main effect for time in a period. Horizontal dashed line at 45° indicates point of equal amounts of EV and knee excursion.

Mentions: There were no group by time interactions. During period 1, all coupling values were unexpectedly lower in the PFPS group, with EV-KADD and EV-KIR couplings being significantly lower (Figure 1). This relatively reduced eversion may have been a compensatory control strategy to minimize the abnormal knee mechanics that often accompany excessive eversion. This period of early loading is important, as the patella is not yet well seated into the femoral trochlea and is vulnerable to malalignment. By period 2, coupling angles were similar between the 2 groups for all relationships. As this is the period of maximal loading, the PFPS group may not have been able to maintain the relatively reduced EV seen in early loading. Over the course of the run, both groups increased their coupling angles in period 1 at the end of the prolonged run compared to the beginning. This may be an indication of fatigue, as EV has been shown to increase over the course of prolonged running [3].


Rearfoot and knee coupling over a prolonged run in runners with patellofemoral pain syndrome
Coupling angle group means during the 2 loading periods of stance at the beginning and end of the run. * = Significant main effect for group in a period. ** = Significant main effect for time in a period. Horizontal dashed line at 45° indicates point of equal amounts of EV and knee excursion.
© Copyright Policy
Related In: Results  -  Collection

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Figure 1: Coupling angle group means during the 2 loading periods of stance at the beginning and end of the run. * = Significant main effect for group in a period. ** = Significant main effect for time in a period. Horizontal dashed line at 45° indicates point of equal amounts of EV and knee excursion.
Mentions: There were no group by time interactions. During period 1, all coupling values were unexpectedly lower in the PFPS group, with EV-KADD and EV-KIR couplings being significantly lower (Figure 1). This relatively reduced eversion may have been a compensatory control strategy to minimize the abnormal knee mechanics that often accompany excessive eversion. This period of early loading is important, as the patella is not yet well seated into the femoral trochlea and is vulnerable to malalignment. By period 2, coupling angles were similar between the 2 groups for all relationships. As this is the period of maximal loading, the PFPS group may not have been able to maintain the relatively reduced EV seen in early loading. Over the course of the run, both groups increased their coupling angles in period 1 at the end of the prolonged run compared to the beginning. This may be an indication of fatigue, as EV has been shown to increase over the course of prolonged running [3].

View Article: PubMed Central - HTML

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Patellofemoral pain syndrome (PFPS) is common in runners and is often related to excessive rearfoot eversion... Increased eversion is known to be associated with increased knee flexion, internal rotation, and reduced adduction... We also expected that these angles would increase to a greater degree in the PFPS group at the end of a prolonged run. 20 runners (18–40 yrs) with PFPS and 20 controls (CON) participated in a prolonged treadmill run averaging 30–45 min... A vector coding method was used to assess the following joint couplings: rearfoot eversion (EV) with knee flexion (KF), adduction (KADD), and internal rotation (KIR)... During period 1, all coupling values were unexpectedly lower in the PFPS group, with EV-KADD and EV-KIR couplings being significantly lower (Figure 1)... This relatively reduced eversion may have been a compensatory control strategy to minimize the abnormal knee mechanics that often accompany excessive eversion... By period 2, coupling angles were similar between the 2 groups for all relationships... As this is the period of maximal loading, the PFPS group may not have been able to maintain the relatively reduced EV seen in early loading... Over the course of the run, both groups increased their coupling angles in period 1 at the end of the prolonged run compared to the beginning... During maximal loading, coupling is generally similar between groups... Finally, both groups increased their coupling angles over the course of the prolonged run.

No MeSH data available.