Is There a Relation between The Lower Extremity Mechanics and Patellofemoral Pain Syndrome?

Year 2022, Volume: 3 Issue: 3, 125 - 131, 15.12.2022

Bahar Kara , Aslı Yeral , Deniz Aslan , Güzin Kaya Aytutuldu , Elif Develi , Ayça Aklar

https://doi.org/10.53811/ijtcmr.1186313

Abstract

Objective: It has been theorized that changes in the lower extremity mechanics may lead to develop Patellofemoral Pain (PFP) in the young population. The present study aims to investigate the effects of lower extremity mechanics on Patellofemoral Pain Syndrome in private university students.
Material-Method: Kujala Patellofemoral Score (KPS) of 400 Yeditepe University students ages of 18-30 years was performed. Students having a less or equal point of 85 in KPS (n=30) and healthy groups randomly selected in students with KPS=100 (n=30) were measured in terms of Feiss Line, navicular drop, subtalar angle, tibial torsion, knee valgus angle, Q angle in standing and supine position and hamstring tightness.
Results: The prevalence of PFP among students was found to be 10.5% (n = 42). In the PFP group, 16 (%53.3) students and in the control group, 3 (%10) students had 2nd Pes Planus (PP). A statistically significant difference was found between groups in navicular drop, subtalar angle, tibial rotation, Q angle in supine and hamstring tightness (p-value <0.05).
Conclusion: The results from this study show that students with PFP have higher severity degrees of pes planus, navicular drop, subtalar angle, tibial torsion, and hamstring tightness than nonpainful students. Therefore, these parameters that are related to lower extremity mechanics may be investigated in PFP examination and be considered while preparing a treatment plan.

Keywords

patellofemoral pain, pes planus, university students

References

• Kuru T, Dereli EE, Yaliman A. Validity of Turkish version of the Kujala patellofemoral score in patellofemoral pain syndrome. Acta Orthop Traumatol Turc 2010;44(2):152-6.
• Fredericson M, Powers CM. Practical management of patellofemoral pain. Clin J Sport Med. 2002;12(1):36-38.
• Willy RW, Hoglund LT, Barton CJ, et al. Patellofemoral Pain. J Orthop Sports Phys Ther. 2019;49(9):CPG1-CPG95.
• Powers CM. The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther 2003;33(11):639-46.
• Sheikh Taha AM, Feldman DS. Painful Flexible Flatfoot. Foot Ankle Clin. 2015;20(4):693-704.
• de Moura Campos Carvalho E Silva AP, Magalhães E, Bryk FF, Fukuda TY. Comparison of isometric ankle strength between females with and without patellofemoral pain syndrome. Int J Sports Phys Ther. 2014;9(5):628-634.
• Post WR. Patellofemoral pain: results of non-operative treatment. Clin Orthop Relat Res 2005; 436:55-59.
• Pourahmadi MR, Ebrahimi Takamjani I, Hesampour K, Shah-Hosseini GR, Jamshidi AA, Shamsi MB. Effects of static stretching of knee musculature on patellar alignment and knee functional disability in male patients diagnosed with knee extension syndrome: A single-group, pretest-posttest trial. Man Ther. 2016;22:179-189.
• 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(4):480-489.
• Willson JD, Davis IS. Lower extremity strength and mechanics during jumping in women with patellofemoral pain. J Sport Rehabil. 2009;18(1):76-90.
• Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O. Scoring of patellofemoral disorders. Arthroscopy. 1993;9(2):159-163.
• 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(5):815-822.
• Magee DJ. Orthopedic physical assessment. 7th ed. St. Louis, MO: Saunders Elsevier; 2008.
• Atak E. Vücut Kitle indeksi ile diz patolojileri ve pes planus ilişkisi. J Exerc Ther Reh 2016; 3:66-71.
• Reurink G, Goudswaard GJ, Oomen HG, et al. Reliability of the active and passive knee extension test in acute hamstring injuries. Am J Sports Med. 2013;41(8):1757-1761.
• Fredriksen H, Dagfinrud H, Jacobsen V, Maehlum S. Passive knee extension test to measure hamstring muscle tightness. Scand J Med Sci Sports 1997;7(5):279-282.
• Dag F, Dal U, Altinkaya Z, et al. Alterations in energy consumption and plantar pressure distribution during walking in young adults with patellofemoral pain syndrome. Acta Orthop Traumatol Turc. 2019;53(1):50-55.
• Kosashvili Y, Fridman T, Backstein D, Safir O, Bar Ziv Y. The correlation between pes planus and anterior knee or intermittent low back pain. Foot Ankle Int. 2008;29(9):910-913.
• Barton CJ, Bonanno D, Levinger P, Menz HB. Foot and ankle characteristics in patellofemoral pain syndrome: a case control and reliability study. J Orthop Sports Phys Ther. 2010;40(5):286-296.
• Mølgaard C, Rathleff MS, Simonsen O. Patellofemoral pain syndrome and its association with hip, ankle, and foot function in 16- to 18-year-old high school students: a single-blind case-control study. J Am Podiatr Med Assoc. 2011;101(3):215-222.
• Dileep KS, Harish K, Mohammed RP. Correlation of rearfoot angle to Q-angle in patellofemoral pain syndrome: a prospective study. Int J Res Orthop 2017;3(4):688-91.
• Hetsroni I, Finestone A, Milgrom C, et al. A prospective biomechanical study of the association between foot pronation and the incidence of anterior knee pain among military recruits. J Bone Joint Surg Br. 2006;88(7):905-908.
• Powers CM, Chen PY, Reischl SF, Perry J. Comparison of foot pronation and lower extremity rotation in persons with and without patellofemoral pain. Foot Ankle Int. 2002;23(7):634-640.
• Levinger P, Gilleard W. An evaluation of the rearfoot posture in individuals with patellofemoral pain syndrome. J Sports Sci Med 2004;3:8-14.
• Kaya D, Doral MN. Is there any relationship between Q-angle and lower extremity malalignment?. Acta Orthop Traumatol Turc. 2012;46(6):416-419.
• Caylor D, Fites R, Worrell TW. The relationship between quadriceps angle and anterior knee pain syndrome. J Orthop Sports Phys Ther. 1993;17(1):11-16.
• Pappas E, Wong-Tom WM. Prospective Predictors of Patellofemoral Pain Syndrome: A Systematic Review With Meta-analysis. Sports Health. 2012;4(2):115-120.
• Myer GD, Ford KR, Barber Foss KD, et al. The incidence and potential pathomechanics of patellofemoral pain in female athletes. Clin Biomech (Bristol, Avon). 2010;25(7):700-707.
• White LC, Dolphin P, Dixon J. Hamstring length in patellofemoral pain syndrome. Physiotherapy. 2009;95(1):24-28.
• Waryasz GR, McDermott AY. Patellofemoral pain syndrome (PFPS): a systematic review of anatomy and potential risk factors. Dyn Med. 2008;7:9.