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Taghipourdarzinaghibi M.1, Hosseinzadeh S.2, Eslami M.2, Salari F.2, Talebighadikolaie G.A.3, Rashidpouraghamahalli F.4, Tayebikermani B.5
1Babol University of Medical Sciences, Mobility Impairment Research Center, Babol, Iran, 2University of Mazandaran, Babolsar, Iran, 3Babol University of Medical Sciences, Babol, Iran, 4MSc of Exercise Physiology, Babol, Iran, 5Mazandaran Gas Company, Sari, Iran
Background: Patellofemoral pain syndrome (PFPS) has been reported as the most common source of anterior knee pain. As the most common injury related to running, PFPS has a different lower extremity kinematics comparing to healthy one.
Purpose: The purpose of present study was to analysis three-dimensional (3-D) ankle kinematics in PFPS patients as well as assessing effects of patellar taping and knee bracing on these variables during stance phase of running.
Methods: A convenient sample of 27 subjects (14 PFPS and 13 healthy subjects) aged between 20-30 years was recruited in this cross sectional study. Ankle three-dimensional kinematics was investigated by using a five-camera 3-D motion analysis system during stance phase of running. The kinematic variables of PFPS patients have been calculated randomly in three conditions
a) without any intervention (PFPS-none),
b) with tape (PFPS-tape) and with brace (PFPS-brace).
Variables were statistically analyzed by repeated measure and independent t-test and P 0.05 was considered for significance.
Results: Results showed that ankle range of motions (ROM) in dorsiflexion, eversion and adduction were significantly greater in PFPS-none group than healthy group. Analysis of ankle joint kinematics in PFPS subgroups by repeated measure demonstrated that dorsiflexion and eversion ROM in PFPS-tape group decreased significantly as compared to PFPS-none (p=0/000) while adduction ROM significantly increased (p=0/016). Comparing variables demonstrated that every three ankle ROM in PFPS-brace group were significantly greater than those of PFPS-none group (p=0/000).
Conclusion(s): The risk of developing PFPS as a result of limited ankle dorsiflexion has been attributed to a series of biomechanical compensations in response to the limited ankle ROM. Specifically; decreased dorsiflexion during weight-bearing tasks limits downward displacement of center of gravity and encourages increased subtalar-joint pronation and tibial internal rotation to gain additional motion. These results may provide further potential explanations for the mechanism behind foot orthoses efficacy in management of PFPS patients. Both therapeutic methods theoretically improve patellar tracking by correcting patellar alignment via centralizing patella within trochlea groove in PFPS subjects.
Implications: The clinicians must consider not only the local problem but also its effects on upper and lower joints in lower limb kinematic chain. In fact, the final goal should be focused on function of lower limb kinematic chain in addition to local problem.
Funding acknowledgements: We thank Babol University of Medical Sciences for financial support.
Topic: Musculoskeletal: lower limb
Ethics approval: The method has been approved by the committee of ethics in research at Babol University of Medical Sciences.
All authors, affiliations and abstracts have been published as submitted.
