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Made available in DSpace on 2022-05-01T09:31:23Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-11-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Objectives: To compare trunk muscle endurance among females and males with and without patellofemoral pain (PFP), and to investigate the correlations between trunk muscle endurance and performance of the single leg hop test (SLHT) and forward step-down test (FSDT). Design: Cross-sectional. Setting: Laboratory-based study. Participants: 110 females and 38 males with PFP, 61 females and 31males without PFP. Main outcome measures: Anterior and lateral trunk muscle endurance were assessed with the prone and bilateral side-bridge tests, respectively. Performance during the SLHT and FSDT was also assessed. Results: Lower anterior and lateral trunk muscle endurance were identified in females (p

Made available in DSpace on 2022-04-29T08:37:15Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-01-01 Medical College of Wisconsin Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Background: Impaired knee extension biomechanics and spinal excitability have been reported in women with patellofemoral pain, but their relationship has not been explored. A significant relationship between them could indicate the need for investigating the potential benefits of disinhibitory interventions for women with patellofemoral pain. Thus, this study aimed to investigate the relationship between vastus medialis Hoffmann reflex and (1) maximal isometric, concentric and eccentric knee extensor strength and rate of torque development; (2) knee extensor torque steadiness; and (3) knee extensor moment during functional tasks; in women with patellofemoral pain. Methods: Spinal excitability of twenty-four participants was assessed by the amplitude of maximal vastus medialis Hoffmann reflex. Knee extensor strength, rate of torque development and torque steadiness were assessed using an isokinetic dynamometer. Knee extensor moment during step-down and stair descent tasks were obtained using a three-dimensional motion analysis system. Findings: A moderate negative relationship was found between vastus medialis Hoffmann reflex and knee extensor torque steadiness (r = −0.35; p = 0.05); whereas a moderate positive relationship was found with maximal isometric knee extensor strength (r = 0.37; p = 0.044). No significant relationships were found between vastus medialis Hoffmann reflex and the other variables. Interpretation: Our findings provide insight on the relationship between spinal excitability and neuromuscular control of maximal and submaximal isometric torque production in women with patellofemoral pain. Conversely, spinal excitability does not seem to be related with dynamic torques and moments of the knee extensors in women with patellofemoral pain. Laboratory of Biomechanics and Motor Control (LABCOM) School of Science and Technology Sao Paulo State University (UNESP), Presidente Prudente La Trobe Sport and Exercise Medicine Research Centre (LASEM) School of Allied Health Human Services and Sport La Trobe University School of Arts Sciences and Humanities University of Sao Paulo Laboratory of Biomechanics and Motor Control (LABCOM) School of Science and Technology Sao Paulo State University (UNESP), Presidente Prudente FAPESP: 2018/07542–7 FAPESP: 2018/12352–2

Made available in DSpace on 2022-04-28T17:22:33Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-10-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Ferreira, AS, de Oliveira Silva, D, Ferrari, D, Magalhaes, FH, Pappas, E, Briani, RV, Pazzinatto, MF, and de Azevedo, FM. Knee and hip isometric force steadiness are impaired in women with patellofemoral pain. J Strength Cond Res 35(10): 2878-2885, 2021-The purposes were as follows: to compare knee extension and hip abduction force steadiness and maximal strength between women with patellofemoral pain (PFP) and pain-free women; and to investigate whether maximal strength, self-reported pain during force-matching tasks, self-reported knee function, symptoms duration, and physical activity level are associated with knee extension and hip abduction force steadiness. Thirty women with PFP and 30 pain-free women were recruited. Knee extension and hip abduction maximal voluntary isometric contractions and submaximal isometric force-matching tasks were evaluated using an isokinetic dynamometer. Subjects were asked to match a target force corresponding to 10% of their maximal isometric voluntary contraction while force steadiness was computed as the coefficient of variation (CV) of the exerted force. Women with PFP had significant 36% lower knee extension and 33% lower hip abduction peak strength. They also had significant 70% lower knee extension force steadiness and 60% lower hip abduction force steadiness (i.e., higher CV) than pain-free women. Self-reported pain and self-reported knee function were significantly associated (r = 0.61, p < 0.001; r = -0.35, p = 0.05) and able to predict 41% of the variance of knee extensor force steadiness. Hip abductor maximum strength was significantly associated (r = -0.57; p = 0.001) and able to predict 32% of the variance of hip abductor force steadiness. These findings indicate that muscle impairments in PFP go beyond only low knee and hip muscle strength because women with PFP also present deficits in knee extension and hip abduction force steadiness. Evidence-based treatments aiming at improving force steadiness may be a promising addition to PFP rehabilitation programs. Sao Paulo State Univ, Sch Sci & Technol, Physiotherapy Dept, Lab Biomech & Motor Control LABCOM,UNESP, Presidente Prudente, SP, Brazil La Trobe Univ, La Trobe Sports & Exercise Med Res Ctr LASEM, Sch Allied Hlth, Bundoora, Vic, Australia Univ Sao Paulo, Sch Arts Sci & Humanities, Sao Paulo, Brazil Univ Sydney, Fac Hlth Sci, Discipline Physiotherapy, Sydney, NSW, Australia Sao Paulo State Univ, Sch Sci & Technol, Physiotherapy Dept, Lab Biomech & Motor Control LABCOM,UNESP, Presidente Prudente, SP, Brazil FAPESP: 2015/11534-1 FAPESP: 2016/02357-1 FAPESP: 2017/06328-9

Made available in DSpace on 2022-04-29T08:45:53Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-09-01 ABSTRACT: Ferreira, AS, de Oliveira Silva, D, Barton, CJ, Briani, RV, Taborda, B, Pazzinatto, MF, and de Azevedo, FM. Impaired isometric, concentric, and eccentric rate of torque development at the hip and knee in patellofemoral pain. J Strength Cond Res 35(9): 2492-2497, 2021-The aims of this study were to compare maximal muscle strength and rate of torque development (RTD) of knee extensor and hip abductor during isometric, concentric, and eccentric contractions between women with and without patellofemoral pain (PFP). Thirty-eight women with PFP (PFPG) and 38 pain-free women (CG) participated in this study. Isometric, concentric, and eccentric maximal torque and RTD of knee extensor and hip abductor were assessed using an isokinetic dynamometer. Rate of torque development was calculated as the change in torque over the change in time from torque onset to 30, 60, and 90% of the maximal torque (RTD30%, RTD60%, and RTD90%) during isometric, concentric, and eccentric contractions. PFPG had lower isometric, concentric, and eccentric knee extensor maximal torque (29.9, 28.3, and 26.7%) compared with the CG. For knee extensor RTD, PFPG had slower isometric RTD30% (17.8%), RTD60% (21.5%), and RTD90% (23.4%); slower concentric RTD30% (35.7%), RTD60% (29.3%), and RTD90% (28.2%); and slower eccentric RTD30% (20.5%), RTD60% (25.2%), and RTD90% (22.5%) compared with the CG. PFPG had lower isometric, concentric, and eccentric hip abductor maximal torque (28.3, 21.8, and 17%) compared with the CG. For hip abductor RTD, PFPG had slower isometric RTD30% (32.6%), RTD60% (31.1%), and RTD90% (25.4%); slower concentric RTD90% (11.5%); and slower eccentric RTD30% (19.8%), RTD60% (26.4%), and RTD90% (24%) compared with the CG. In conclusion, women with PFP presented deficits in both maximal strength and RTD of knee extensor and hip abductor during isometric, concentric, and eccentric contractions, which highlight the potential importance of addressing different aspects of muscle function through exercise therapy. Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), President Prudente, Sao Paulo, Brazil; and Physiotherapy Department La Trobe Sports and Exercise Medicine Research Center (LASEM) School of Allied Health La Trobe University, Bundoora

Made available in DSpace on 2021-06-25T10:18:47Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-03-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Objectives: To compare trunk and knee biomechanics of women with and without patellofemoral pain (PFP) and knee crepitus during stair ascent. Design: Cross-sectional. Setting: Laboratory-based study. Participants: 29 women with PFP and knee crepitus (PFPCrepitus); 28 women with PFP and no knee crepitus (PFPNOCrepitus); 17 pain-free women with knee crepitus (Pain-freeCrepitus); and 29 pain-free women without knee crepitus (Pain-freeNOCrepitus). Main outcome measures: Peak trunk flexion, peak knee flexion, mean knee angular velocity, knee extensor moment at peak knee flexion, peak and impulse of the knee extensor moment. Results: PFPCrepitus group performed the stair ascent task with reduced peak knee flexion compared to Pain-freeCrepitus (p = 0.04; Effect size = −0.85) and Pain-freeNOCrepitus (p = 0.03; Effect size = −0.75). No significant differences among groups were found for peak trunk flexion (p = 0.979), knee angular velocity (p = 0.420), knee extensor moment at peak knee flexion (p = 0.933), peak (p = 0.290) and impulse (p = 0.122) of the knee extensor moment. Conclusion: Women with concomitant PFP and knee crepitus demonstrated reduced knee flexion during stair ascent, but no significant differences for trunk flexion and knee extensor moment variables were found. Sao Paulo State University (UNESP) School of Science and Technology Physical Therapy Department University of Toledo School of Exercise and Rehabilitation Sciences La Trobe Sports and Exercise Medicine Research Centre (LASEM) School of Allied Health La Trobe University Sao Paulo State University (UNESP) School of Science and Technology Physical Therapy Department FAPESP: 2019/03214-8

Made available in DSpace on 2021-06-25T10:37:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Background: Although it is assumed that the presence of patellofemoral pain (PFP) may result in compensatory behaviors that can alter trunk kinematics and lower limb mechanics, the influence of the exacerbation of patellofemoral pain on trunk kinematics and lower limb mechanics during stair negotiation has not been established. Research question: Does the exacerbation of PFP symptoms lead to altered trunk kinematics and lower limb mechanics during stair negotiation? Methods: Three-dimensional kinematics and kinetics were obtained from 45 women with PFP during stair descent and ascent. Data were obtained before and after a pain exacerbation protocol. The variables of interest were peak trunk, hip, and knee flexion, and ankle dorsiflexion; peak hip, and knee extensor, and ankle plantarflexor moments. Paired t-tests were used to compare the variables of interest before and after pain exacerbation. Results: Following pain exacerbation, there was a decrease in peak knee extensor moment during stair descent (Effect size = −0.68; p = 0.01) and stair ascent (Effect size = −0.56; p = 0.02); as well as in peak ankle dorsiflexion during stair descent (Effect size = −0.33; p = 0.01) and stair ascent (Effect size = −0.30; p = 0.01). An increase in ankle plantarflexor moment during stair descent (Effect size = 0.79; p < 0.01) and stair ascent (Effect size = 0.89; p < 0.01) was also observed. No significant differences were observed for peak trunk, hip, and knee flexion or hip extensor moment (p > 0.05). Significance: Our findings show compensatory strategies used by people with PFP in response to symptoms exacerbation that may have a negative impact on knee and ankle mechanics. Our findings also suggest that people with PFP do not seem to change their trunk, hip, and knee flexion or hip extensor moment during stair negotiation in response to symptom exacerbation. Laboratory of Biomechanics and Motor Control (LABCOM) School of Science and Technology Sao Paulo State University (UNESP), Presidente Prudente Musculoskeletal Biomechanics Research Laboratory Division of Biokinesiology and Physical Therapy University of Southern California Exercise Neuroscience Research Group School of Arts Sciences and Humanities University of São Paulo Laboratory of Biomechanics and Motor Control (LABCOM) School of Science and Technology Sao Paulo State University (UNESP), Presidente Prudente FAPESP: 2016/03262-4

Made available in DSpace on 2021-06-25T10:14:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Background: Deficits in knee flexor strength and rate of torque development (RTD) might be present in women with patellofemoral pain (PFP). In addition, maximal strength and RTD of the knee flexors and extensors might be related with subjective and objective function in women with PFP. However, both conjectures are still poorly understood. Research question: Do women with PFP have deficits in the maximal strength and RTD of the knee flexors and extensors during isometric, concentric, and eccentric contractions? Is there a relationship between maximal strength and RTD of the knee flexors and extensors with subjective and objective function in women with PFP? Methods: Fifty-six women with, and 46 women without, PFP participated. Maximal strength and RTD (to 30% and 60% maximal torque) during isometric, concentric, and eccentric contractions of the knee flexors and extensors were assessed using an isokinetic dynamometer. Objective assessment included single leg hop test (SLHT) and forward step-down test (FSDT). Subjective assessment involved the anterior knee pain scale. Results: Women with PFP had small to large deficits in maximal strength and RTD of the knee flexors and extensors during isometric, concentric and eccentric contractions (Effect sizes: -0.43 to -1.10; p ≤ 0.016). Small to moderate correlations of maximal concentric and eccentric knee flexor strength and RTD with SLHT and FSDT (r = 0.28 to 0.41; p ≤ 0.037) were identified. Subjective or objective function were not correlated with maximal isometric knee flexor strength and RTD, or any knee extensor measures (p > 0.05). Significance: Maximal strength and RTD deficits of the knee flexors and extensors were identified in this female PFP cohort, but they were unrelated to subjective function. The relationship of concentric and eccentric knee flexor strength and RTD deficits with poor objective function should be considered in future exercise trials for women with PFP. Laboratory of Biomechanics and Motor Control (LABCOM) School of Science and Technology Sao Paulo State University (UNESP) La Trobe Sport and Exercise Medicine Research Centre (LASEM) School of Allied Health Human Services and Sport La Trobe University Department of Surgery St Vincent's Hospital University of Melbourne Laboratory of Biomechanics and Motor Control (LABCOM) School of Science and Technology Sao Paulo State University (UNESP)

The incidence of falls is high in elderly and the fear of falls is between the universal occurences of falls in this population. In this sense, the study has by objective evaluate the balance and the fear of falls in elderly woman participants of physical activity and sedentaries. Were evaluated 30 ederly of feminine sex divided into two groups: therapeutic exercise and sedentarism. All groups were evaluated using the Montreal Cognitive Assessment (MoCA), Falls Efficacy Scale (FES-I-Brasil) and Tinetti Balance Scale. The results showed significative difference on fear of falls (20.09±3.7 vs 37.72±8.7; p=0.000), balance and march (27.77±0.5 vs 18.40±3.9; p

Background Systematic reviews provide the best evidence about the effectiveness of healthcare interventions. Although systematic reviews are conducted with explicit and transparent methods, discrepancies might occur between the protocol and the publication. Objectives To estimate the proportion of systematic reviews of physical therapy interventions that are registered, the methodological quality of (un)registered systematic reviews and the prevalence of outcome reporting bias in registered systematic reviews. Methods A random sample of 150 systematic reviews published in 2015 indexed on the PEDro database. We included systematic reviews written in English, Italian, Portuguese and Spanish. A checklist for assessing the methodological quality of systematic reviews tool was used. Relative risk was calculated to explore the association between meta-analysis results and the changes in the outcomes. Results Twenty-nine (19%) systematic reviews were registered. Funding and publication in a journal with an impact factor higher than 5.0 were associated with registration. Registered systematic reviews demonstrated significantly higher methodological quality (median = 8) than unregistered systematic reviews (median = 5). Nine (31%) registered systematic reviews demonstrated discrepancies between protocol and publication with no evidence that such discrepancies were applied to favor the statistical significance of the intervention (RR = 1.16; 95% CI: 0.63–2.12). Conclusion A low proportion of systematic reviews in the physical therapy field are registered. The registered systematic reviews showed high methodological quality without evidence of outcome reporting bias. Further strategies should be implemented to encourage registration.

This study investigated whether women with patellofemoral pain (PFP) present kinematic alterations in proximal, local, and distal factors simultaneously, and determined the association between the number of kinematic alterations, pain level, and functional status. A three-dimensional motion analysis system was used to analyze the peak hip adduction, peak knee flexion, and peak rearfoot eversion, addressing the proximal, local, and distal factors, respectively, in fifty women. Functional status and pain level were assessed using the anterior knee pain scale (AKPS) and a visual analogic scale. Receiver operating characteristic curves were calculated to identify participants with and without kinematic alterations and the number of them was obtained for each participant. Associations between the number of kinematic alterations, pain level, and AKPS score were determined by the Pearson correlation. Results showed that 52% of women with PFP presented at least two kinematic alterations of which 24% were local/proximal, 16% local/distal, and 12% proximal/distal. Three kinematic alterations were found in 48% of the women with PFP. A strong positive correlation was found between the number of kinematic alterations and pain (r=0.78; p

Highlights • Intense physical activity can lead to higher levels of PFP. • Asymptomatic women were not influenced by the PFJ loading protocol. • The PFJ loading protocol has the capability to equalize pain in women with PFP., Background Physical activity levels seem to play a role in patellofemoral pain (PFP); however, few studies have been conducted to confirm this hypothesis. Objectives To determine the reported pain levels of women with and without PFP who maintain different levels of physical activity; to determine the capability of these levels to predict pain; and to test the capability of two stair-negotiation protocols, with and without external load, to equalize pain between groups. Method Four groups were divided based on the women's physical activity levels: moderate activity PFP group (28), moderate activity control group (23), intense activity PFP group (22), and intense activity control group (22). All participants were asked to perform 15 repetitions of stair negotiation with and without external load on a seven-step staircase on two separate days. Pain levels were reported using a visual analog scale at five distinct moments: previous month, before stair negotiation, after stair negotiation, before patellofemoral joint (PFJ) loading protocol, and after PFJ loading protocol. Results The intense activity PFP group showed higher levels of pain than the moderate activity PFP group (F(8,158) = 11.714, p = 0.000, η2 = 0.30). The PFJ loading protocol was able to equalize and exacerbate pain in the PFP groups. Conclusion Intense physical activity seems to have a higher association with knee pain than moderate physical activity. A PFJ loading protocol may be an alternative to equalize pain in women with PFP during clinical assessments.

BACKGROUND AND OBJECTIVES: Walking is described as one of the abilities most affected by chronic low back pain. This study aimed to determine if chronic nonspecific low back pain and walking speed affect the spatiotemporal parameters (stride length, swing time, contact time, stride time, stride frequency and walking ratio) and the coefficients of variation of stride length and contact time. METHODS: Ten participants with chronic nonspecific low back pain (low back pain - LG) and ten healthy participants in the control group (CG) walked on the treadmill at preferred self-selected speed, slower and faster than the preferred speed. Spatiotemporal parameters and coefficients of variation were determined by kinematic analysis. Main effects (group and speed) and their interactions were tested using generalized estimating equations method. RESULTS: Our results showed that there were no significant differences between groups or significant interaction between group and speed factors. There was a speed effect. Stride frequency and length increased while contact and stride time decreased as the speed increased. The walking ratio (stride length/stride frequency) was relatively consistent across speeds (~1.6 m·stride-1.s) without statistical differences. The coefficients of variation were below 5%. CONCLUSION: The chronic nonspecific low back pain did not affect the gait spatiotemporal profile, at least for those patients classified as chronic nonspecific low back pain according to the signs and symptoms criteria. Although the preferred speed has affected the spatiotemporal parameters, both groups patients were able to adjust their kinematic parameters to each task demand. RESUMO JUSTIFICATIVA E OBJETIVOS: A caminhada é descrita como uma das habilidades mais afetadas pela dor lombar crônica. Este estudo objetivou determinar se a dor lombar crônica não específica e a velocidade de caminhada afetam os parâmetros espaço-temporais (comprimento da passada, tempo de balanço, tempo de contato, tempo da passada, frequência da passada e razão de caminhada) e os coeficientes de variação do comprimento da passada e do tempo de contato. MÉTODOS: Dez participantes com dor lombar crônica não específica (grupo dor lombar GL) e 10 participantes saudáveis (grupo controle - GC) caminharam na esteira na velocidade preferida autosselecionada, e em velocidades mais lenta e mais rápida que a velocidade preferida. Parâmetros espaço-temporais e coeficientes de variação foram determinados por cinemetria. Os efeitos principais (grupo e velocidade) e as suas interações foram testadas pelo método de equações de Estimativas Generalizadas. RESULTADOS: Não houve diferenças entre os grupos ou interação entre os fatores (grupo e velocidade). Houve efeito da velocidade. A frequência e o comprimento de passada aumentaram, enquanto o tempo de contato e de passada diminuíram à medida que a velocidade aumentou. A razão de caminhada (comprimento da passada/frequência da passada) foi relativamente consistente entre as velocidades (~1,6 m·passada-1·s) sem diferenças estatísticas. Os coeficientes de variação ficaram abaixo dos 5%. CONCLUSÃO: A dor lombar crônica não específica não afetou os parâmetros espaço-temporais da caminhada, pelo menos para os pacientes classificados com dor lombar crônica não específica pelos critérios de sinais e sintomas. Embora a velocidade preferida tenha afetado os parâmetros espaço-temporais, os pacientes de ambos os grupos foram hábeis para ajustar seus parâmetros cinemáticos às demandas da tarefa.

Made available in DSpace on 2020-12-10T22:49:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-10-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Fundacao Araucaria, Brazil Objectives-To compare trunk muscle thickness of women with and without patellofemoral pain (PFP) and to assess the association of trunk muscle thickness with self-reported pain of women with PFP. Methods-Forty-four women were recruited and divided into 2 groups: a PFP group (n = 22) and a pain-free group (n = 22). The thickness of the following trunk muscles was obtained by B-mode ultrasound imaging: transversus abdominis, obliquus internus (OI), obliquus externus (OE), rectus abdominis, and multifidus. Self-reported pain was measured on a visual analog scale. Results-The 44 participants were 18 to 35 years old. Women with PFP had lower thickness of the OI and OE than pain-free women, with moderate or large effect sizes ranging from -0.78 to -0.98, which was negatively related to self-reported pain correlations (r = -0.53 to -0.40). The contraction ratios of the OI and OE were also lower in women with PFP than in pain-free women (P

Introdução: O Traumatismo Cranioencefálico (TCE) é uma das principais causas de incapacidade funcional e alteração motora na população adulta. Objetivo: Avaliar o efeito da terapia com Wii no deslocamento do COP de hemiplégicos devido à sequela TCE. Métodos: Foram realizadas 10 sessões de treinamento com o Nintendo Wii Fit® em 10 indivíduos hemiplégicos pós TCE, do sexo masculino, com média de 31,3 ± 2,9 anos de idade. Foram avaliados antes e após o protocolo de treinamento e mais uma após 3 meses, nas quais mediu-se os dados cinéticos. Resultados: Não foram encontradas diferenças na RMS e velocidade do deslocamento do COP nos sentidos ântero-posterior e médio-lateral dos sujeitos hemiplégicos após as 10 sessões de treinamento com o console Wii. Esses valores se mantiveram após 3 meses. Conclusão: A terapia com o console Wii não alterou o deslocamento do COP nos sentidos ântero-posterior e médio-lateral de indivíduos com hemiplegia.

Background Altered hip, knee and foot kinematics have been systematically observed in individuals with patellofemoral pain (PFP). However, less attention has been given to the altered dynamic postural control associated with PFP. Additionally, the relative contribution of kinematic impairments to the postural behavior of subjects with PFP remains an open question that warrants investigation. The aims of this study were: i) to investigate possible differences in hip adduction, rearfoot eversion, knee flexion and displacement area of the center of pressure (COP) in individuals with PFP in comparison to controls during stair ascent; and (ii) to determine which kinematic parameter is the best predictor of the displacement area of the COP measured during the stance phase of the stair ascent. Methods Twenty-nine females with PFP and 25 asymptomatic pain-free females underwent three-dimensional kinematic and COP analyses during stair ascent. Between-group comparisons were made using independent t-tests. Regression models were performed to identify the capability of each kinematic factor in predicting the displacement area of the COP. Results Reduced knee flexion and displacement area of the COP as well as increased peak hip adduction and peak rearfoot eversion were observed in individuals with PFP as compared to controls. Peak hip adduction was the best predictor of the displacement area of the COP (r 2 =23.4%). Conclusions The excessive hip adduction was the biggest predictor of the displacement area of the COP. Clinical relevance Based on our findings, proximally targeted interventions may be of major importance for the functional reestablishment of females with PFP.

Made available in DSpace on 2018-11-26T17:55:59Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-10-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Objective. Compare pressure pain thresholds (PPTs) at the knee and a site remote to the knee in female adults with patellofemoral pain (PFP) to pain-free controls before and after a patellofemoral joint (PFJ) loading protocol designed to aggravate symptoms. Design. Cross-sectional study Setting. Participants were recruited via advertisements in fitness centers, public places for physical activity and universities. Subjects. Thirty-eight females with patellofemoral pain, and 33 female pain-free controls. Methods. All participant performed a novel PFJ loading protocol involving stair negotiation with an extra load equivalent 35% of body mass. PPTs and current knee pain (measured on a visual analogue scale) was assessed before and after the loading protocol. PPTs were measured at four sites around the knee and one remote site on the upper contralateral limb. Results. Females with PFP demonstrated significantly lower PPTs locally and remote to the knee, both before and after the PFJ loading protocol when compared to control group. Following the loading protocol, PPTs at knee were significantly reduced by 0.54 kgf (95% CI = 0.33; 0.74) for quadriceps tendon, 0.38 kgf (95% CI = 0.14; 0.63) for medial patella, and 0.44 kgf (95% CI = 0.18; 0.69) for lateral patella. No significant change in PPT remote to the knee was observed -0.10 kgf (95% CI = -0.04; 0.24). Conclusions. Female adults with PFP have local and widespread hyperalgesia compared to pain free controls. A novel loading protocol designed to aggravate symptoms, lowers the PPTs locally at the knee but has no effect on PPT on the upper contralateral limb. This suggests widespread hyperalgesia is not affected by acute symptom aggravation. Univ Sao Paulo State, Phys Therapy Dept, Sch Sci & Technol Presidente Prudente, Presidente Prudente, Brazil La Trobe Univ, Dept Phys Therapy, Sch Allied Hlth, Coll Sci Hlth & Engn, Bundoora, Vic, Australia Queen Mary Univ London, Ctr Sports & Exercise Med, London, England Aalborg Univ, Res Unit Gen Practice, Aalborg, Denmark Aalborg Univ, Dept Clin Med, Aalborg, Denmark FAPESP: 2014/24939-7 : 2014/10839-0 : 2015/11534-1

Increased knee abductor moment (KAM) is thought to be related with elevated patellofemoral joint (PFJ) stress, a major contributor to patellofemoral pain (PFP). Knowing which parameter of the KAM relates with PFJ stress and self-reported pain is important as interventions can vary depending on the altered KAM parameter. This study aimed to compare peak, rate of moment development and impulse of KAM and PFJ stress of women with PFP and pain-free controls during stair descent; and to investigate the relationship among these variables with self-reported pain. Sixty-four women aged 18–35 years were recruited. A three-dimensional motion analysis system with link-segment models and inverse-dynamics equations was used to obtain kinetic data during a stair descent task. A previously reported algorithmic model was used to determine patellofemoral contact force (PCF) and patellofemoral contact pressure (PCP), indicatives of PFJ stress. Self-reported pain was assessed using a visual analogue scale (VAS). Women with PFP presented higher peak, rate of moment development and impulse of the KAM, PCF and PCP during stair descent than pain-free controls, suggesting women with PFP experience higher levels of PFJ stress while descending stairs. Only KAM impulse presented positive moderate correlations with self-reported pain, PCF and PCP. These findings indicate that strategies aimed at decreasing KAM impulse could reduce the load over the PFJ and improve pain of women with PFP.

Made available in DSpace on 2018-12-11T17:37:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-09-01 Objectives: (i) To assess the reliability of knee crepitus measures, (ii) to investigate the association between knee crepitus and PFP; (iii) to investigate the relationship between knee crepitus with self-reported function, physical activity and pain. Design: Cross-sectional. Setting: Laboratory-based study. Participants: 165 women with PFP and 158 pain-free women. Main outcome measures: Knee crepitus test, anterior knee pain scale (AKPS) and self-reported worst knee pain in the last month, knee pain after 10 squats and knee pain after 10 stairs climbing. Results: Knee crepitus clinical test presented high reliability Kappa value for PFP group was 0.860 and for pain-free group was 0.906. There is a significantly greater proportion of those with crepitus in the PFP group than in the pain-free group (OR = 4.19). Knee crepitus had no relationship with function (rpb = 0.03; p = 0.727), physical activity level (rpb = 0.010; p = 0.193), worst pain (rpb = 0.11; p = 0.141), pain climbing stairs (rpb = 0.10; p = 0.194) and pain squatting (rpb = 0.02; p = 0.802). Conclusion: Women who presents knee crepitus have 4 times greater odds to be in a group with PFP compared to those who do not. However, knee crepitus has no relationship with self-reported clinical outcomes of women with PFP. Laboratory of Biomechanics and Motor Control School of Science and Technology São Paulo State University (UNESP) La Trobe Sports and Exercise Medicine Research Centre School of Allied Health La Trobe University School of Exercise & Rehabilitation Sciences College of Health and Human Services Department of Athletic Training University of Toledo Laboratory of Biomechanics and Motor Control School of Science and Technology São Paulo State University (UNESP)

Made available in DSpace on 2018-12-11T16:52:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-06-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Background: The etiology of patellofemoral pain (PFP) is thought to be the result of increased patellofemoral joint (PFJ) load and aberrant lower extremity mechanics, including altered vertical ground reaction forces (VGRF). However, few studies have investigated the association between an increase in pain and VGRF loading rates in the context of PFP. Thus, this study aimed to investigate the immediate effects of PFJ loading on pain and VGRF loading rate, and to see if there is a link between modification of both pain and VGRF loading rate during stair negotiation. Methods: Thirty-four women with PFP underwent VGRF analysis during stair negotiation under two conditions: with (condition 2) and without (condition 1) being previously submitted to a PFJ loading protocol in order to or not to exacerbate their knee pain, respectively. Results: The VGRF loading rates were significantly higher in condition 2 (Mean ± standard deviation (SD) = 4.0 ± 0.6 N/s) compared to condition 1 (Mean ± SD = 3.6 ± 0.5 N/s) during stair ascent and during stair descent (Mean ± SD: condition 1 = 6.3 ± 1.1 N/s; condition 2 = 7.0 ± 1.4 N/s). In addition, VGRF loading rates were higher during stair descent compared to stair ascent in both conditions. There were significant correlations between the increase in pain and VGRF loading rate during both tasks. Conclusion: There seemed to be an important relation between the increase in pain and VGRF loading rates in women with PFP. Based on these findings, interventions aimed at reducing VGRF loading rates are important in the context of PFP. Physical Therapy Department School of Science and Technology São Paulo State University (UNESP) La Trobe University School of Allied Health La Trobe Sports and Exercise Medicine Research Centre (LASEM) Physical Therapy Department School of Science and Technology São Paulo State University (UNESP) FAPESP: 2014/24939-7

Background The elevated Q-angle seems to be one of the most suggested factors contributing to patellofemoral pain. Females with patellofemoral pain are often evaluated through static clinical tests in clinical practice. However, the adaptations seem to appear more frequently in dynamic conditions. Performing static vs. dynamic evaluations of widely used measures would add to the knowledge in this area. Therefore, the aim of this study was to determine the reliability and discriminatory capability of three Q-angle measurements: a static clinical test, peak dynamic knee valgus during stair ascent and a static measurement using a three-dimensional system. Method Twenty-nine females with patellofemoral pain and twenty-five pain-free females underwent clinical Q-angle measurement and static and dynamic knee valgus measurements during stair ascent, using a three-dimensional system. All measurements were obtained and comparisons between groups, reliability and discriminatory capability were calculated. Findings Peak dynamic knee valgus was found to be greater in the patellofemoral pain group. On the other hand, no significant effects were found for static knee valgus or clinical Q-angle measurements between groups. The dynamic variable demonstrated the best discriminatory capability. Low values of reliability were found for clinical Q-angle, in contrast to the high values found for the three-dimensional system measurements. Interpretation Based on our findings, avoiding or correcting dynamic knee valgus during stair ascent may be an important component of rehabilitation programs in females with patellofemoral pain who demonstrate excessive dynamic knee valgus. Q-angle static measurements were not different between groups and presented poor values of discriminatory capability.

Reliability is essential to all aspects of the measure, as it shows the quality of the information and allows rational conclusions with regard to the data. There has been controversial results regarding the reliability of electromyographic parameters assessed during stair ascent and descent in individuals with patellofemoral pain syndrome (PFPS). Therefore, this study aims to determine the reliability of time and frequency domain electromyographic parameters on both gestures in women with PFPS. Thirty-one women with PFPS were selected to participate in this study. Data from vastus lateralis and medialis were collected during stair deambulation. The selected parameters were: automatic onset, median frequency bands of low, medium and high frequency. Reliability was determined by intraclass correlation coefficient and the standard error of measurement. The frequency domain variables have shown good reliability, with the stair ascent presenting the best rates. On the other hand, onset has proved to be inconsistent in all measures. Our findings suggest that stair ascent is more reliable than stair descent to evaluate subjects with PFPS in the most cases. A reprodutibilidade é essencial para todos os aspectos da medida, uma vez que mostra a qualidade da informação e permite conclusões racionais no que diz respeito aos dados. Além disso, os resultados são controversos sobre parâmetros eletromiográficos avaliados durante a subida e descida de escada em indivíduos com síndrome da dor femoropatelar (SDFP). Portanto pretende-se determinar a reprodutibilidade de parâmetros eletromiográficos nos domínios do tempo e da frequência em ambos os gestos em mulheres com SDFP. Foram selecionadas 31 mulheres com SDFP. Os dados dos músculos vasto lateral e vasto medial foram coletados durante a subida e a descida de escada. Os parâmetros selecionados foram: o onset automático, frequência mediana, bandas de baixa, média e alta frequência. Determinou-se a reprodutibilidade através do coeficiente de correlação intraclasse e do erro padrão da medida. As variáveis no domínio da frequência apresentaram boa reprodutibilidade, com a subida apresentando os melhores índices, e o onset mostrou-se inconsistente. Os resultados sugerem que a subida de escada é mais confiável do que a descida da escada para avaliar indivíduos com SDPF na maioria dos casos. La reproducibilidad es esencial para todos los aspectos de la medida, ya que muestra la calidad de la información y permite conclusiones racionales con respecto a los datos. Además, los resultados son controvertidos en parámetros electromiográficos evaluados durante el ascenso y descenso escaleras en las personas con síndrome de dolor patelofemoral (SDPF). Por eso tenemos la intención de determinar la reproducibilidad de los parámetros electromiográficos en el tiempo y la frecuencia en ambos gestos en mujeres con SDPF. 31 mujeres com SDPF fueron seleccionadas. Se recogieron datos del vasto lateral y medial durante ascenso y descenso de escaleras. Los parámetros seleccionados fueron: inicio automático, frecuencia mediana, bandas de baja, media y alta frecuencia. La reproducibilidad se determinó mediante el coeficiente de correlación intraclase y el error estándar de medición. Las variables en el dominio de la frecuencia mostraron buena reproducibilidad, el ascenso presentó lós mejores índices, y el inicio demostró ser inconsistente. Estos resultados sugieren que el ascenso de la escalera es más confiable que el descenso para evaluar individuos con SDPF en la mayoría de los casos.

Background Despite its high incidence, patellofemoral pain etiology remains unclear. No prior study has compared surface electromyography frequency domain parameters and surface electromyography time domain variables, which have been used as a classic analysis of patellofemoral pain. Methods Thirty one women with patellofemoral pain and twenty eight pain-free women were recruited. Each participant was asked to descend a seven step staircase and data from five successful trials were collected. During the task, the vastus medialis and vastus lateralis muscle activities were monitored by surface electromyography. The data were processed and analyzed in four variables of the frequency domain (median frequency, low, medium and high frequency bands) and three time domain variables (Automatic, Cross-correlation and Visual Onset between the vastus medialis and vastus lateralis muscles). Reliability, Receiver Operating Characteristic curves and regression models were performed. Findings The medium frequency band was the most reliable variable and different between the groups for both muscles, also demonstrated the best values of sensitivity and sensibility, 72% and 69% for the vastus medialis and 68% and 62% for the vastus lateralis, respectively. The frequency variables predicted the pain of individuals with patellofemoral pain, 26% for the vastus medialis and 20% for the vastus lateralis, being better than the time variables, which achieved only 7%. Interpretation The frequency domain parameters presented greater reliability, diagnostic accuracy and capacity to predict pain than the time domain variables during stair descent and might be a useful tool to diagnose individuals with patellofemoral pain.

Made available in DSpace on 2019-10-06T16:04:16Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-02-01 Background: Evidence indicates the presence of both kinesiophobia and knee extension strength deficits in women with patellofemoral pain (PFP). Both impairments may contribute to apparent compensatory gait patterns including reduced cadence and peak knee flexion during stair negotiation. Research question: Is kinesiophobia or knee extension strength associated with movement pattern in women with patellofemoral pain? Methods: Forty women with PFP were assessed with three-dimensional kinematic analyses during stair descent; isokinetic dynamometry of the knee extensors (isometric, concentric and eccentric); and the Tampa scale for kinesiophobia. Pearson coefficients were calculated to determine relationship among variables. Results: Kinesiophobia correlated significantly with cadence (r = −0.62, p < 0.001), and peak knee flexion (r = −0.76, p < 0.001). No significant correlations were found between any knee extensor strength variables and kinematics (cadence or peak knee flexion); or kinesiophobia (p > 0.05). Significance: Findings of this study could suggest addressing strength impairments alone may not adequately address kinesiophobia and movement pattern impairments in women with PFP. However, high-quality randomised controlled trials are needed to test this assumption. Further value may be added if currently evidence-based knee strengthening exercise is combined with education and/or graded exposure to address kinesiophobia, and consideration to gait retraining to address altered movement patterns at the knee. Laboratory of Biomechanics and Motor Control (LABCOM) School of Science and Technology Sao Paulo State University (UNESP) La Trobe Sports and Exercise Medicine Research Centre (LASEM) School of Allied Health La Trobe University Translating Research Knowledge Evidence (TREK) group La Trobe University, Kingsbury Drive São Paulo State University (UNESP) School of Science and Technology Presidente Prudente Laboratory of Biomechanics and Motor Control (LABCOM) School of Science and Technology Sao Paulo State University (UNESP) São Paulo State University (UNESP) School of Science and Technology Presidente Prudente

Introdução: A forma mais acessível para diagnosticar dores lombares e sacroilíacas são os testes ortopédicos. Objetivo: Apresentar confiabilidade e acurácia diagnóstica por meio dos índices de sensibilidade e especificidade de testes clínicos para avaliar a coluna lombar e articulações sacroilíacas. Métodos: Realizou-se revisão de literatura com palavras-chave e seus correspondentes em inglês, nas bases de dados: PubMed, Embase, SciELO e Bireme. Resultados: Encontraram-se 9.806 artigos, porém apenas sete foram incluídos no estudo. Os principais testes para avaliação da coluna lombar são: slump test, teste de Lasègue, teste de Schöber e de instabilidade segmentar. Para avaliar as disfunções sacroilíacas: teste de distração, compressão, thigh thrust, Gaenslen e teste de thrust sacral. Conclusão: O slump test e o teste de Lasègue apresentaram valores excelentes de especificidade e sensibilidade no diagnóstico de disfunções lombares. Os testes para avaliação sacroilíaca evidenciaram que dois ou mais testes positivos combinados demonstram melhores resultados nos índices estudados.

Background Excessive rearfoot eversion is thought to be a risk factor for patellofemoral pain development, due to the kinesiological relationship with ascendant adaptations. Individuals with patellofemoral pain are often diagnosed through static clinical tests, in scientific studies and clinical practice. However, the adaptations seem to appear in dynamic conditions. Performing static vs. dynamic evaluations of widely used measures would add to the knowledge in this area. Thus, the aim of this study was to determine the reliability and differentiation capability of three rearfoot eversion measures: rearfoot range of motion, static clinical test and static measurement using a three-dimensional system. Method A total of 29 individuals with patellofemoral pain and 25 control individuals (18–30 years) participated in this study. Each subject underwent three-dimensional motion analysis during stair climbing and static clinical tests. Intraclass correlation coefficient and standard error measurements were performed to verify the reliability of the variables and receiver operating characteristic curves to show the diagnostic accuracy of each variable. In addition, analyses of variance were performed to identify differences between groups. Findings Rearfoot range of motion demonstrated higher diagnostic accuracy (an area under the curve score of 0.72) than static measures and was able to differentiate the groups. Only the static clinical test presented poor and moderate reliability. Other variables presented high to very high values. Interpretation Rearfoot range of motion was the variable that presented the best results in terms of reliability and differentiation capability. Static variables do not seem to be related to patellofemoral pain and have low accuracy values.

Background Several hypotheses have been proposed to explain the pathomechanisms underlying patellofemoral pain (PFP). Concurrent evaluation of lower limb mechanics in the same PFP population is needed to determine which may be more important to target during rehabilitation. This study aimed to investigate possible differences in rearfoot eversion, hip adduction, and knee flexion during stair ascent; the relationship between these variables; and the discriminatory capability of each in identifying females with PFP. Method Thirty-six females with PFP and 31 asymptomatic controls underwent three-dimensional kinematic analyses during stair ascent. Between-group comparisons were made for peak rearfoot eversion, hip adduction, and knee flexion. Pearson's correlation coefficients were calculated to evaluate relationships among these parameters. Receiver operating characteristic curves were applied to identify the discriminatory capability of each. Findings Females with PFP ascended stairs with reduced peak knee flexion, greater peak hip adduction and peak rearfoot eversion. Peak hip adduction (> 10.6°; sensitivity = 67%, specificity = 77%) discriminated females with PFP more effectively than rearfoot eversion (> 5.0°; sensitivity = 58%, specificity = 67%). Reduced peak hip adduction was found to be associated with reduced peak knee flexion (r = 0.54, p = 0.002) in females with PFP. Interpretation These findings indicate that proximal, local, and distal kinematics should be considered in PFP management, but proximally targeted interventions may be most important. The relationship of reduced knee flexion with reduced hip adduction also indicates a possible compensatory strategy to reduce patellofemoral joint stress, and this may need to be addressed during rehabilitation.

Made available in DSpace on 2018-11-26T16:32:55Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-01-01 The authors investigated the effects of chronic low back pain (LBP) and walking speed (WS) on metabolic power and cost of transport (CT). Subjects with chronic nonspecific LBP (LBP group [LG]; n = 9) and healthy (control group [CG]; n = 9) were included. The test battery was divided into 3 blocks according to WS as follows: preferred self-selected speed (PS), and lower and higher than the PS. In each block, the volunteers walked 5min, during which oxygen consumption was measured. Although without differences between groups, the LG had CT lower in slower speeds than in faster speeds. Walking speed affected CT only in the LG, which the group had the greatest walking economy at slower speeds. Univ Estadual Oeste Parana, Clin Fisioterapia Unioeste, Fisioterapia, Rua Univ 2069, BR-85819110 Cascavel, Brazil Univ Estadual Paulista, Fisioterapia, Presidente Prudente, Brazil Univ Estadual Santa Catarina, Educ Fis, Florianopolis, SC, Brazil Univ Fed Rio Grande do Sul, Educ Fis, BR-90046900 Porto Alegre, RS, Brazil Univ Estadual Paulista, Fisioterapia, Presidente Prudente, Brazil

The purpose of this study was to analyze the test-retest reliability of the median frequency (MDF) and root mean square (RMS) used to determine the onset of neuromuscular fatigue (NF) during sustained fatiguing contractions of the quadriceps. Eighteen healthy men were tested on two days, and electromyographic (EMG) signals were recorded from the vastus medialis (VM), rectus femoris (RF) and vastus lateralis (VL) during sustained isometric contractions at 20 and 70% of maximum voluntary contractions (MVC) held until exhaustion. The reliability of endurance time was excellent at 20% MVC and poor at 70% MVC. EMG variables were evaluated: (1) at the beginning of the test; (2) at NF; and (3) at the end of the test. The NF time values presented poor reliability. The MDF has shown, in general, poor reliability at 20 and 70% MVC, whereas the RMS reliability presented better results for both loads, especially for RF, followed by the VM and VL muscles. The MDF and RMS values extracted from NF showed poor reliability at 20 and 70% MVC, which suggests caution in using these variables extracted from the EMG signal to determine the onset of NF.

Objective : Comparison of the biomechanical parameters (spatiotemporal and kinetic) during walking of young people, falling, and non-falling elderly persons. Methods : A cross-sectional study was performed of 29 individuals divided into three groups: young persons (n=10); falling elderly individuals (n=7) and non-falling individuals (n=12). Gait analysis was performed based on the recording of three walking gait cycles along an 8 meter platform, which was attached to a force plate with a recording frequency of 200 Hz. Gait cycles were also recorded by three video cameras positioned perpendicular to the force plate with a recording frequency of 60 Hz. The data analyzed was: average step velocity, stance time, Froude number and anteroposterior ground reaction force. Results : The average step velocity was higher among young persons and there was no difference in the Froude number among the three groups. During the stance and impulse phase, anterior and posterior force was higher among young persons than in the non-falling elderly group. The foot stance time of young individuals was also lower than the non-falling elderly group (p=0.000) and the foot stance time of the falling elderly group was lower than that of the non-falling elderly group (p=0.004). Conclusion : Falling and non-falling elderly persons have different gait biomechanical characteristics than young women, other than with respect to the Froude number. Furthermore, falling elderly persons spend more time in the gait swing phase than non-falling elderly persons. Objetivo : Comparar parâmetros biomecânicos espaço-temporais e cinéticos da caminhada de jovens, idosas caidoras e não caidoras. Metodologia : Estudo transversal composto por 29 indivíduos divididos em três grupos: Grupo Jovens (n=10); Grupo Idosas Caidoras (n=7) e Grupo Idosas não Caidoras (n=12). Realizou-se análise biomecânica da marcha por meio da gravação de três ciclos de marcha ao longo de uma passarela de caminhada de 8 metros, na qual havia inserida uma plataforma de força no seu centro com frequência de amostragem de 200 Hz. Os ciclos de marcha também foram gravados por três câmeras de vídeo posicionadas perpendicularmente à plataforma de força com frequência de amostragem de 60 Hz. Os dados analisados foram: velocidade média da passada, tempo de apoio do membro, número de Froude e força anteroposterior de reação do solo. Resultados : A velocidade média foi maior no Grupo Jovens e o número de Froude foi igual entre os três grupos. Durante a fase de apoio, a força no sentido anterior foi maior no Grupo Jovens comparado ao Grupo Idosas não Caidoras, sendo da mesma forma durante a fase de impulso. Também foi encontrado menor tempo de apoio do Grupo Jovens em relação ao Grupo Idosas Caidoras (p=0,000) e menor tempo de apoio do Grupo Idosas Caidoras em relação ao Grupo Idosas não Caidoras (p=0,004). Conclusão : Idosas caidoras e não caidoras apresentam características biomecânicas da marcha diferentes de mulheres jovens, exceto pelo número de Froude. Além disso, idosas caidoras permanecem mais tempo na fase de balanço que idosas não caidoras.

Deslocamento do disco intervertebral; Artrodese; Ortopedia.

Made available in DSpace on 2022-04-28T19:02:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-12-01 Individuals with patellofemoral pain (PFP) use different motor strategies during unipodal support in stair climbing activities, which may be assessed by vertical ground reaction force parameters. Thus, the aims of this study were to investigate possible differences in first peak, valley, second peak, and loading rate between recreational female athletes with PFP and pain-free athletes during stair climbing in order to determine the association and prediction capability between these parameters, pain level, and functional status in females with PFP. Thirty-one recreational female athletes with PFP and 31 pain-free recreational female athletes were evaluated with three-dimensional kinetics while performing stair climbing to obtain vertical ground reaction force parameters. A visual analog scale was used to evaluate the usual knee pain. The anterior knee pain scale was used to evaluate knee functional score. First peak and loading rate were associated with pain (r =.46, P =.008; r =.56, P =.001, respectively) and functional limitation (r =.31, P =.049; r = -.36, P =.032, respectively). Forced entry regression revealed the first peak was a significant predictor of pain (36.5%) and functional limitation (28.7%). Our findings suggest that rehabilitation strategies aimed at correcting altered vertical ground reaction force may improve usual knee pain level and self-reported knee function in females with PFP. University of São Paulo State Physical Therapy Department School of Science and Technology University of São Paulo Program Interunits Bioengineering EESC FMRP IQSC-USP State University of West Parana Physical Therapy Department

Made available in DSpace on 2018-12-11T16:41:22Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-02-01 The aims of this study were to examine group differences in muscle activation onset of the vastus medialis (VM) in relation to the vastus lateralis (VL) and pain level during stair ascent in females with patellofemoral pain (PFP) who maintain high and moderate levels of physical activity; to determine the association between physical activity level and muscle activation onset. Forty-three females with PFP and thirty-eight pain-free females were recruited and divided into four groups based on their level of physical activity: females with PFP (n = 26) and pain-free females (n = 26) who practiced a moderate level of physical activity and females with PFP (n = 17) and pain-free females (n = 12) who practiced an intense amount of physical activity. Participants were asked to ascend a seven-step staircase and the VM and VL activation onset was determined. Females with PFP who practiced high level of physical activity demonstrated delayed onset of VM (4.06 ms) compared to healthy females (-14.4 ms). Conversely, females with PFP who practiced moderate level of physical activity did not present VM delay (-2.48 ms) in comparison to healthy females (-9.89 ms). Furthermore, physical activity significantly correlated to the muscle activation onset difference (p = 0.005; R = 0.60). These findings may explain why controversial results regarding VM and VL muscle activation onset have been found. Department of Physiotherapy University of State of Sao Paulo UNESP Department of Bioengineering University of São Paulo USP Department of Physiotherapy University of State of Sao Paulo UNESP

RESUMO Este estudo teve como objetivo avaliar a capacidade dos testes clínicos de mensuração do ângulo Q e pronação subtalar em predizer a dor e as limitações funcionais referidas por indivíduos com Síndrome da Dor Femoropatelar (SDFP). Trinta e um indivíduos com SDFP foram recrutados para este estudo. O questionário Anterior Knee Pain Scale foi utilizado para identificar as limitações funcionais, e a Escala Visual Analógica de dor para a dor vivenciada por esses indivíduos referente ao último mês. Foram realizados dois testes clínicos estáticos, mensuração do ângulo Q e mensuração da postura da pronação subtalar. Os valores dos testes foram inseridos em modelos de regressão linear e múltipla para a obtenção do R2 e dos coeficientes de regressão para medidas não contínuas padronizadas com o nível de significância estabelecido em α=0,05. Ambos os testes, quando inseridos isoladamente em modelos de regressão lineares, obtiveram resultados baixos de predição de dor e função. Por outro lado, quando inseridos conjuntamente em modelos de regressão múltipla, os testes explicaram 9% e 4% da dor e das limitações funcionais de indivíduos com SDFP, respectivamente. Embora tenha sido observada melhora da predição da dor e limitação funcional quando os testes foram avaliados em conjunto, os achados deste estudo mostram que ambas as medidas - ângulo Q e pronação subtalar - não são bons preditores de dor e limitações funcionais de indivíduos com SDFP.a prática do método Pilates, houve melhora na atividade física de lazer, mobilidade toracoabdominal, força muscular respiratória e redução da circunferência da cintura. No entanto, em comparação com o Grupo Controle, o método Pilates não promoveu alterações relevantes na função pulmonar, mobilidade toracoabdominal, força muscular respiratória e características antropométricas de mulheres saudáveis que não realizaram programa de exercício físico. RESUMEN El objetivo de este estudio fue evaluar la capacidad de de las pruebas clínicas de medición del ángulo Q y pronación subtalar en predecir el dolor y las limitaciones funcionales mencionados por individuos con Síndrome de Dolor Femoropatelar (SDFP). Treinta y un individuos con SDFP fueron reclutados para este estudio. El cuestionario Anterior Knee Pain Scale fue utilizado para identificar las limitaciones funcionales; mientras la Escala Visual Analógica del dolor para identificar el dolor experimentado por los individuos en el último mes. Se realizaron dos ensayos clínicos estadísticos, medición del ángulo Q y medición de la postura de la pronación subtalar. Los valores de las pruebas fueron insertados en modelos de regresión linear y múltiple para obtener el R2 y los coeficientes de regresión para medidas no continuas estandarizadas con el nivel de significancia establecido en α=0,05. Ambas pruebas cuando insertadas aisladamente en modelos de regresión lineares obtuvieron resultados bajos de predicción de dolor y función. Por otro lado, cuando insertados en modelos de regresión múltiple, los ensayos explicaron el 9% y 4% del dolor y de las limitaciones funcionales de individuos con SDFP, respectivamente. Aunque hubo mejora de la predicción del dolor y de la limitación funcional cuando las pruebas se evaluaron juntas, los resultados de este estudio muestran que ambas las medidas, el ángulo Q y la pronación subtalar, no son buenos predictores del dolor y de las limitaciones funcionales de individuos con SDFP. ABSTRACT This study aimed to evaluate the clinical trials' ability in Q angle measurement and subtalar pronation to predict the pain and functional limitations alluded by individuals with Patellofemoral Pain Syndrome (PFPS). Thirty-one individuals with PFPS were recruited for this study. The Anterior Knee Pain Scale questionnaire was used to identify the functional limitations and the Visual Analogue Scale of pain was used to identify the pain experienced by these individuals in the last month. Two clinical trials were performed, measurement of Q angle and posture measurement of the subtalar pronation. The values of the tests were inserted into linear and multiple regression models to obtain the R2and the coefficients of regression for non-continuous measures standardized with the significance level established at α = 0.05. Both tests when placed separately in linear regression models obtained low results for predicting pain and function. On the other hand, when inserted together in multiple regression models the tests explained 9% and 4% of the pain and of the functional limitations of individuals with PFPS, respectively. Although the prediction of pain and functional limitations has improved when the tests were evaluated together, our findings show that both measures, Q angle and subtalar pronation, are not good predictors of pain and functional limitations of individuals with PFPS.

Background Stair ascent is an activity that exacerbates symptoms of individuals with patellofemoral pain. The discomfort associated with this activity usually results in gait modification such as reduced knee flexion in an attempt to reduce pain. Although such compensatory strategy is a logical approach to decrease pain, it also reduces the normal active shock absorption increasing loading rates and may lead to deleterious and degenerative changes of the knee joint. Thus, the aims of this study were (i) to investigate whether there is reduced knee flexion in adults with PFP compared to healthy controls; and (ii) to analyze loading rates in these subjects, during stair climbing. Method Twenty-nine individuals with patellofemoral pain and twenty-five control individuals (18–30 years) participated in this study. Each subject underwent three-dimensional kinematic and kinetic analyses during stair climbing on two separate days. Between-groups analyses of variance were performed to identify differences in peak knee flexion and loading rates. Intraclass correlation coefficient was performed to verify the reliability of the variables. Findings On both days, the patellofemoral pain group demonstrated significantly reduced peak knee flexion and increased loading rates. In addition, the two variables obtained high to very high reliability. Interpretation Reduced knee flexion during stair climbing as a strategy to avoid anterior knee pain does not seem to be healthy for lower limb mechanical distributions. Repeated loading at higher loading rates may be damaging to lower limb joints.

DOI: 10.15448/1980-6108.2017.1.25250 Aims: To compare the level of pain, physical activity, and quality of life of female and male adolescents with patellofemoral pain. Methods: A total of 46 female adolescents and 46 male adolescents aged 12 to 18 years were recruited from public and private schools in the town of Presidente Prudente, Sao Paulo, Brazil. To be included in the study, adolescents needed to report knee pain of insidious onset, exacerbated in some activities, and lasting for at least 6 weeks. In addition, adolescents should report worse pain over the previous week of at least 30 mm on the Visual Analog Scale and could not show signs, symptoms or any occurrence of any other knee dysfunction. The participants were requested to mark their self-reported knee pain in the last month on a Visual Analog Scale. The level of physical activity was evaluated by the Baecke Questionnaire of Habitual Physical Activity and the quality of life subscale of the Knee Outcome in Osteoarthritis Survey questionnaire was used to investigate the participants’ quality of life. The independent t-test was used to find differences between the groups regarding the level of physical activity, quality of life, and knee pain. Results: According to the Visual Analog Scale, male adolescents presented a level of knee pain of 5.1±1.4 in the previous month and female adolescents, of 4.4±1.6 (p = 0.029). The physical activity score was 8.8±1.3 for male adolescents and 7.5±1.6 for female ones (p

Objetivos: Avaliar o efeito da caminhada em esteira na acuidade proprioceptiva do tornozelo de mulheres jovens saudaveis. Metodos: Para este ensaio clinico randomizado foram selecionadas 20 mulheres entre 18 e 30 anos com um nivel baixo de atividade fisica segundo a classificacao IPAQ (Questionario Internacional de Nivel de Atividade Fisica). As participantes foram divididas em dois grupos de 10 componentes, o Grupo Exercicio, que realizou 10 sessoes de caminhada em esteira, e o Grupo Controle, que nao foi submetido a nenhuma intervencao. A acuidade proprioceptiva do tornozelo foi avaliada pre e pos-intervencao por meio do Star Excursion Balance Test . Apos ser confirmada a normalidade dos dados, foi utilizada a analise de variância com delineamento misto para comparacao entre os grupos e entre as avaliacoes pre e pos-intervencao. Resultados: Nao foram encontradas diferencas significativas na execucao do Star Excursion Balance Test comparando as avaliacoes pre e pos-intervancao em ambos os grupos. Tambem nao foram encontradas diferencas entre os dois grupos comparando as variacoes percentuais entre as duas avaliacoes. Conclusoes: Nas condicoes testadas, um programa de 10 sessoes de caminhada em esteira nao foi capaz de promover adaptacoes na acuidade proprioceptiva do tornozelo em mulheres jovens saudaveis.