Seyed Hamed Mousavi1, Juha M Hijmans2, Reza Rajabi3, Ron Diercks4, Johannes Zwerver5, Henk van der Worp5. 1. University of Groningen, University Medical Center Groningen, Department of Sports and Exercise Medicine, The Netherlands. Electronic address: s.h.mousavi@umcg.nl. 2. University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands. 3. University of Tehran, Faculty of Physical Education and Sport Sciences, Department of Health and Sport Medicine, Tehran, Iran. 4. University of Groningen, University Medical Center Groningen, Department of Orthopedic Surgery, The Netherlands. 5. University of Groningen, University Medical Center Groningen, Department of Sports and Exercise Medicine, The Netherlands.
Abstract
INTRODUCTION: Abnormal kinematics have been implicated as one of the major risk factors for lower limb tendinopathy (LLT). OBJECTIVE: To systematically review evidence for kinematic risk factors for LLT in runners. METHODS: Individual electronic searches in PubMed, EMBASE and Web of Science were conducted. Two reviewers screened studies to identify observational studies reporting kinematic risk factors in runners with LLT compared to healthy controls. The Down and Black appraisal scale was applied to assess quality. A meta-analysis was performed provided that at least two studies with similar methodology reported the same factor. RESULTS: Twenty-eight studies were included: Achilles tendinopathy (AT) (9), iliotibial band syndrome (ITBS) (17), plantar fasciopathy (PF) (2), patellar tendinopathy (PT) (1), posterior tibial tendon dysfunction (PTTD) (1). Eighteen studies were rated high-quality and ten medium-quality. The meta-analyses revealed strong evidence of higher peak knee internal rotation, moderate evidence of lower peak rearfoot eversion and knee flexion at heel strike and greater peak hip adduction in runners with ITBS. Very limited evidence revealed higher peak ankle eversion in runners with PF and PTTD or higher peak hip adduction in PT. SIGNIFICANCE: Peak rearfoot eversion was the only factor reported in all included LLTs; it is a significant factor in ITBS, PT and PTTD but not in AT and PF. More prospective studies are needed to accurately evaluate the role of kinematic risk factors as a cause of LLT. Taken together, addressing rearfoot kinematic and kinematic chain movements accompanied by peak eversion should be considered in the prevention and management of LLT.
INTRODUCTION: Abnormal kinematics have been implicated as one of the major risk factors for lower limb tendinopathy (LLT). OBJECTIVE: To systematically review evidence for kinematic risk factors for LLT in runners. METHODS: Individual electronic searches in PubMed, EMBASE and Web of Science were conducted. Two reviewers screened studies to identify observational studies reporting kinematic risk factors in runners with LLT compared to healthy controls. The Down and Black appraisal scale was applied to assess quality. A meta-analysis was performed provided that at least two studies with similar methodology reported the same factor. RESULTS: Twenty-eight studies were included: Achilles tendinopathy (AT) (9), iliotibial band syndrome (ITBS) (17), plantar fasciopathy (PF) (2), patellar tendinopathy (PT) (1), posterior tibial tendon dysfunction (PTTD) (1). Eighteen studies were rated high-quality and ten medium-quality. The meta-analyses revealed strong evidence of higher peak knee internal rotation, moderate evidence of lower peak rearfoot eversion and knee flexion at heel strike and greater peak hip adduction in runners with ITBS. Very limited evidence revealed higher peak ankle eversion in runners with PF and PTTD or higher peak hip adduction in PT. SIGNIFICANCE: Peak rearfoot eversion was the only factor reported in all included LLTs; it is a significant factor in ITBS, PT and PTTD but not in AT and PF. More prospective studies are needed to accurately evaluate the role of kinematic risk factors as a cause of LLT. Taken together, addressing rearfoot kinematic and kinematic chain movements accompanied by peak eversion should be considered in the prevention and management of LLT.
Authors: Rachel Mason; Liam T Pearson; Gillian Barry; Fraser Young; Oisin Lennon; Alan Godfrey; Samuel Stuart Journal: Sports Med Date: 2022-10-15 Impact factor: 11.928
Authors: Seyed Hamed Mousavi; Laurens van Kouwenhove; Reza Rajabi; Johannes Zwerver; Juha M Hijmans Journal: PLoS One Date: 2021-02-10 Impact factor: 3.240
Authors: Eleuterio A Sánchez Romero; Joel Pollet; Sebastián Martín Pérez; José Luis Alonso Pérez; Alberto Carlos Muñoz Fernández; Paolo Pedersini; Carlos Barragán Carballar; Jorge Hugo Villafañe Journal: Medicina (Kaunas) Date: 2020-07-28 Impact factor: 2.430