Kathryn C Hickey Lucas1, Cale Jacobs2, Christian Lattermann3, Brian Noehren4. 1. Department of Physical Therapy, University of Kentucky, Lexington, KY, United States of America. 2. Department of Physical Therapy, University of Kentucky, Lexington, KY, United States of America; Department of Orthopaedic Surgery & Sports Medicine, University of Kentucky, Lexington, KY, United States of America. 3. Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, MA, United States of America. 4. Department of Physical Therapy, University of Kentucky, Lexington, KY, United States of America; Department of Orthopaedic Surgery & Sports Medicine, University of Kentucky, Lexington, KY, United States of America. Electronic address: b.noehren@uky.edu.
Abstract
BACKGROUND: Abnormal tracking of the patella is a hallmark sign of patellar instability (PI). Gait deviations and strength deficits may exacerbate abnormal tracking. The identification of modifiable gait deviations and strength deficits can aid in developing more effective management strategies for individuals with PI. The purpose of this study was to identify modifiable gait and strength deficits in subjects with PI. METHODS: 32 subjects (16 PI, 16 controls, 3 males/13 females in each group, 21.1 years old, 23.5 BMI), performed an instrumented gait analysis while walking at 1.5 m per second. Subjects' peak hip adduction angles, external rotation angles, hip abduction moments, knee flexion angles, knee adduction angles, and knee extensor moments were measured during walking. Hip abduction, hip external rotation, and knee extension strength were assessed with a handheld dynamometer. RESULTS: Individuals with PI displayed significantly lower peak knee adduction angles (1.8 ± 2.8° PI, 5.5 ± 4.5° control, p < .01) and peak hip abduction moments (0.2 ± 0.1 Nm/kg*m PI, 0.4 ± 0.1 Nm/kg*m control, p < .01). Subjects with PI were weaker in knee extension strength (14.5 ± 4.1 kg/m PI, 23.8 ± 7.2 kg/m control, p < .01), hip abduction strength (12.1 ± 2.0 kg/m PI, 17.8 ± 4.0 kg/m control, p < .01), and hip external rotation strength (5.5 ± 1.9 kg/m PI, 7.1 ± 1.3 kg/m control, p = .01). CONCLUSION: Subjects with patellar instability have smaller joint moments and a more valgus knee position while walking. Coupled with deficits in muscle strength, this likely contributes to subjective reports of chronic patellar instability. LEVEL OF EVIDENCE: III.
BACKGROUND: Abnormal tracking of the patella is a hallmark sign of patellar instability (PI). Gait deviations and strength deficits may exacerbate abnormal tracking. The identification of modifiable gait deviations and strength deficits can aid in developing more effective management strategies for individuals with PI. The purpose of this study was to identify modifiable gait and strength deficits in subjects with PI. METHODS: 32 subjects (16 PI, 16 controls, 3 males/13 females in each group, 21.1 years old, 23.5 BMI), performed an instrumented gait analysis while walking at 1.5 m per second. Subjects' peak hip adduction angles, external rotation angles, hip abduction moments, knee flexion angles, knee adduction angles, and knee extensor moments were measured during walking. Hip abduction, hip external rotation, and knee extension strength were assessed with a handheld dynamometer. RESULTS: Individuals with PI displayed significantly lower peak knee adduction angles (1.8 ± 2.8° PI, 5.5 ± 4.5° control, p < .01) and peak hip abduction moments (0.2 ± 0.1 Nm/kg*m PI, 0.4 ± 0.1 Nm/kg*m control, p < .01). Subjects with PI were weaker in knee extension strength (14.5 ± 4.1 kg/m PI, 23.8 ± 7.2 kg/m control, p < .01), hip abduction strength (12.1 ± 2.0 kg/m PI, 17.8 ± 4.0 kg/m control, p < .01), and hip external rotation strength (5.5 ± 1.9 kg/m PI, 7.1 ± 1.3 kg/m control, p = .01). CONCLUSION: Subjects with patellar instability have smaller joint moments and a more valgus knee position while walking. Coupled with deficits in muscle strength, this likely contributes to subjective reports of chronic patellar instability. LEVEL OF EVIDENCE: III.
Authors: Brian Noehren; Cale Jacobs; Benjamin D Brightwell; Austin Stone; Xiaojuan Li; Peter Hardy; Katherine Thompson Journal: Trials Date: 2022-01-28 Impact factor: 2.279
Authors: Andreas Habersack; Tanja Kraus; Annika Kruse; Katharina Regvar; Michael Maier; Martin Svehlik Journal: Int J Environ Res Public Health Date: 2022-08-23 Impact factor: 4.614