Knee and rearfoot alignment´s assessment in womans with and without patellofemoral pain during squat exercise
DOI:
https://doi.org/10.11606/issn.2317-0190.v25i3a162645Keywords:
Patellofemoral Pain Syndrome, Flatfoot, Resistance TrainingAbstract
The Squatting, considered a complex biomechanical movement due to requiring dynamic alignment, is a frequently practiced exercise. If performed in the wrong way, it can become a risk rese for osteomioarticular lesions, such as patellofemoral pain. Objective: The objective of this study was to evaluate the alignment of the knees and the rearfoot during the squatting exercise in women with and without patellofemoral pain. Method: Twenty-five women, aged between 19 and 37 years, were trained for at least six months, who reported knee pain during functional activities. The sample was recruited in four academies of the Taquari Valley. After the application of a Questionnaire, which addressed the intensity and behavior of patellofemoral pain, the volunteers were divided into two groups: 14 with patellofemoral pain and 11 without patellofemoral pain. The execution of the squat exercise and the Step Down Test were recorded to evaluate the alignment of the knees and rearfoot in these functional activities. Results: The data were analyzed using descriptive statistics, Student’s t-test and Pearson’s correlation, with a significance level of p <0.05. There was no difference between the variables, comparing the group with and without patellofemoral pain. The participants with higher angular values of static valgus tend to resente the same characteristic during the Step Down test. Conclusion: An individualized evaluation approach is necessary, with the subgrouping according to the pain’s etiology. It is questioned the classification of biomechanical alterations as cause or effect of patellofemoral pain and compensations performed.
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Souza GL, Moreira NB, Campos W. Ocorrência e características de lesões entre praticantes de musculação. Saúde e Pesquisa. 2015;8(3):469-77. DOI: https://doi.org/10.17765/2176-9206.2015v8n3p469-477
Baroni BM, Bruscatto CA, Rech RR, Trentin L, Brum LR. Prevalência de alterações posturais em praticantes de musculação. Fisioter Mov.23(1):129-39. DOI: http://dx.doi.org/10.1590/S0103-51502010000100013
Shields RK, Madhavan S, Gregg E, Leitch J, Petersen B, Salata S, et al. Neuromuscular control of the knee during a resisted single-limb squat exercise. Am J Sports Med. 2005;33(10):1520-6. DOI: https://doi.org/10.1177/0363546504274150
Gusmão TMR, Ribeiro KLS, Granja KSB, Sant’Ana HGF, Machado AP. Desempenho funcional do exercício de agachamento. Ciênc Biol Saúde. 2015;2(3):45-56.
Graci V, Salsich GB. Trunk and lower extremity segment kinematics and their relationship to pain following movement instruction during a single-leg squat in females with dynamic knee valgus and patellofemoral pain. J Sci Med Sport. 2015;18(3):343-7. DOI: https://doi.org/10.1016/j.jsams.2014.04.011
Lee TQ, Morris G, Csintalan RP. The influence of tibial and femoral rotation on patellofemoral contact area and pressure. J Orthop Sports Phys Ther. 2003;33(11):686-93. DOI: https://doi.org/10.2519/jospt.2003.33.11.686
Wilson T. The measurement of patellar alignment in patellofemoral pain syndrome: are we confusing assumptions with evidence? J Orthop Sports Phys Ther. 2007;37(6):330-41. DOI: https://doi.org/10.2519/jospt.2007.2281
Prins MR, van der Wurff P. Females with patellofemoral pain syndrome have weak hip muscles: a systematic review. Aust J Physiother. 2009;55(1):9-15. DOI: https://doi.org/10.1016/S0004-9514(09)70055-8
Julian R, Hecksteden A, Fullagar HH, Meyer T. The effects of menstrual cycle phase on physical performance in female soccer players. PLoS One. 2017;12(3):e0173951. DOI: https://doi.org/10.1371/journal.pone.0173951
Peccin MS, Ciconelli R, Cohen M. Questionário específico para sintomas do joelho "Lysholm Knee Scoring Scale" – tradução e validação para a língua portuguesa. Acta Ortop Bras. 2006;14(5):268-72. DOI: https://doi.org/10.1590/S1413-78522006000500008
Duarte F. Utilização terapêutica de palmilhas ortopédicas no ambiente esportivo. PROFISIO. 2012;2:109-42.
Almeida GPL, Silva APMCC, França FJR, Magalhães MO, Burke TN, Marques AP. Ângulo-q na dor patelofemoral: relação com valgo dinâmico de joelho, torque abdutor do quadril, dor e função. Rev Bras Ortop. 2016;51(2):181-6. DOI: https://doi.org/10.1016/j.rboe.2016.01.010
Kaukinen PT, Arokoski JP, Huber EO, Luomajoki HA. Intertester and intratester reliability of a movement control test battery for patients with knee osteoarthritis and controls. J Musculoskelet Neuronal Interact. 2017;17(3):197-208.
Ortiz A, Micheo W. Biomechanical evaluation of the athlete's knee: from basic science to clinical application. PM R. 2011;3(4):365-71. DOI: https://doi.org/10.1016/j.pmrj.2010.12.005
Sheehan FT, Derasari A, Fine KM, Brindle TJ, Alter KE. Q-angle and J-sign: indicative of maltracking subgroups in patellofemoral pain. Clin Orthop Relat Res. 2010;468(1):266-75. DOI: https://doi.org/10.1007/s11999-009-0880-0
Macri EM, Stefanik JJ, Khan KK, Crossley KM. Is tibiofemoral or patellofemoral alignment or trochlear morphology associated with patellofemoral osteoarthritis? a systematic review. Arthritis Care Res (Hoboken). 2016;68(10):1453-70. DOI: https://doi.org/10.1002/acr.22842
Park SK, Stefanyshyn DJ. Greater Q angle may not be a risk factor of patellofemoral pain syndrome. Clin Biomech (Bristol, Avon). 2011;26(4):392-6. DOI: https://doi.org/10.1016/j.clinbiomech.2010.11.015
Pappas E, Wong-Tom WM. Prospective predictors of patellofemoral pain syndrome: a systematic review with meta-analysis. Sports Health. 2012;4(2):115-20. DOI: https://doi.org/10.1177/1941738111432097
Padua DA, Bell DR, Clark MA. Neuromuscular characteristics of individuals displaying excessive medial knee displacement. J Athl Train. 2012;47(5):525-36. DOI: https://doi.org/10.4085/1062-6050-47.5.10
Rabin A, Kozol Z, Spitzer E, Finestone A. Ankle dorsiflexion among healthy men with different qualities of lower extremity movement. J Athl Train. 2014;49(5):617-23. DOI: https://doi.org/10.4085/1062-6050-49.3.14
Dill KE, Begalle RL, Frank BS, Zinder SM, Padua DA. Altered knee and ankle kinematics during squatting in those with limited weight-bearing-lunge ankle-dorsiflexion range of motion. J Athl Train. 2014;49(6):723-32. DOI: https://doi.org/10.4085/1062-6050-49.3.29
Petersen W, Ellermann A, Gösele-Koppenburg A, Best R, Rembitzki IV, Brüggemann GP, et al. Patellofemoral pain syndrome. Knee Surg Sports Traumatol Arthrosc. 2014;22(10):2264-74. DOI: https://doi.org/10.1007/s00167-013-2759-6
Petersen W, Rembitzki I, Liebau C. Patellofemoral pain in athletes. Open Access J Sports Med. 2017;8:143-54. DOI: https://doi.org/10.2147/OAJSM.S133406
Wilson NA, Press JM, Koh JL, Hendrix RW, Zhang LQ. In vivo noninvasive evaluation of abnormal patellar tracking during squatting in patients with patellofemoral pain. J Bone Joint Surg Am. 2009;91(3):558-66. DOI: https://doi.org/10.2106/JBJS.G.00572
Kagaya Y, Fujii Y, Nishizono H. Association between hip abductor function, rear-foot dynamic alignment, and dynamic knee valgus during single-leg squats and drop landings. J Sport Health Sci. 2015;4(2):182-7. DOI: https://doi.org/10.1016/j.jshs.2013.08.002
Wyndow N, De Jong A, Rial K, Tucker K, Collins N, Vicenzino B, et al. The relationship of foot and ankle mobility to the frontal plane projection angle in asymptomatic adults. J Foot Ankle Res. 2016;9:3. DOI: https://doi.org/10.1186/s13047-016-0134-9
van der Heijden RA, Kanter JL, Bierma-Zeinstra SM, Verhaar JA, van Veldhoven PL, Krestin GP, et al. Structural Abnormalities on Magnetic Resonance Imaging in Patients With Patellofemoral Pain: A Cross-sectional Case-Control Study. Am J Sports Med. 2016;44(9):2339-46. DOI: https://doi.org/10.1177/0363546516646107
Bittencourt NF, Ocarino JM, Mendonça LD, Hewett TE, Fonseca ST. Foot and hip contributions to high frontal plane knee projection angle in athletes: a classification and regression tree approach. J Orthop Sports Phys Ther. 2012;42(12):996-1004. DOI: https://doi.org/10.2519/jospt.2012.4041
Herbst KA, Barber Foss KD, Fader L, Hewett TE, Witvrouw E, Stanfield D, et al. Hip strength is greater in athletes who subsequently develop patellofemoral pain. Am J Sports Med. 2015;43(11):2747-52. DOI: https://doi.org/10.1177/0363546515599628
Reis JG, Costa GC, Cliquet Junior A, Piedade SR. Análise cinemática do joelho ao subir e descer escada na instabilidade patelofemoral. Acta Ortop Bras. 2009; 17(3):152-4. DOI: https://doi.org/10.1590/S1413-78522009000300005
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