Physiotherapy theory and practice · 2025
Influence of patellofemoral joint reaction force changes at small knee flexion angles on patellofemoral pain during single limb landing in active females.
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Atkins Lee T, Yang Hyung Suk, James C Roger
Аннотация
BACKGROUND: Excessive patellofemoral joint (PFJ) loading is considered a primary stimulus for patellofemoral pain (PFP) development. However, little is known about how changes in PFJ loading influence PFP in active females, who are affected more frequently than males.
PURPOSE: Examine if changes in the patellofemoral joint reaction force (PFJRF) caused by forward trunk lean are associated with changes in self-reported PFP and hip and knee kinematics during single limb landing. Examine if and to what extent PFJRF reductions are related to changes in self-reported PFP.
METHODS: Twenty-six active females (age: 23.4 ± 4.1 years) with PFP performed five single limb landing trials (0.25 m) using self-selected and forward trunk lean strategies. For each trial, kinematics, kinetics, and self-reported PFP were recorded. Dependent variables included pain, peak PFJRF, and PFJRF at varying knee flexion angles. Paired t-tests and Wilcoxon signed rank tests were calculated to examine the forward trunk lean effects on dependent variables. Spearman's rho was calculated to examine relationships between changes in PFJRF and self-reported PFP.
RESULTS: Forward trunk lean led to increased peak PFJRF (mean difference (MD) = 16.15 N/kg; p < .05) and decreased PFJRF at knee flexion angles of 20 (MD = -5.73 N/kg; p < .001), 25 (MD = -7.67 N/kg; p < .001), and 30 degrees (MD = -6.86 N/kg; p < .001), but not 35 degrees (p > .05). The forward trunk lean also led to a 3-point median decrease in PFP (p < .05) and abolished pain in 18 of 26 participants, despite increased peak PFJRF. The PFJRF change at 25 degrees of knee flexion was significantly and positively related to changes in self-reported PFP (ρ = .44; p = .026).
CONCLUSIONS: For active females, increased forward trunk lean during single limb landing can improve PFP and reduce PFJRFs at small knee flexion angles, despite increased peak PFJRF. Additionally, greater decreases in the submaximal PFJRF at 25 degrees of knee flexion were associated with greater decreases in self-reported PFP during single limb landing.
PURPOSE: Examine if changes in the patellofemoral joint reaction force (PFJRF) caused by forward trunk lean are associated with changes in self-reported PFP and hip and knee kinematics during single limb landing. Examine if and to what extent PFJRF reductions are related to changes in self-reported PFP.
METHODS: Twenty-six active females (age: 23.4 ± 4.1 years) with PFP performed five single limb landing trials (0.25 m) using self-selected and forward trunk lean strategies. For each trial, kinematics, kinetics, and self-reported PFP were recorded. Dependent variables included pain, peak PFJRF, and PFJRF at varying knee flexion angles. Paired t-tests and Wilcoxon signed rank tests were calculated to examine the forward trunk lean effects on dependent variables. Spearman's rho was calculated to examine relationships between changes in PFJRF and self-reported PFP.
RESULTS: Forward trunk lean led to increased peak PFJRF (mean difference (MD) = 16.15 N/kg; p < .05) and decreased PFJRF at knee flexion angles of 20 (MD = -5.73 N/kg; p < .001), 25 (MD = -7.67 N/kg; p < .001), and 30 degrees (MD = -6.86 N/kg; p < .001), but not 35 degrees (p > .05). The forward trunk lean also led to a 3-point median decrease in PFP (p < .05) and abolished pain in 18 of 26 participants, despite increased peak PFJRF. The PFJRF change at 25 degrees of knee flexion was significantly and positively related to changes in self-reported PFP (ρ = .44; p = .026).
CONCLUSIONS: For active females, increased forward trunk lean during single limb landing can improve PFP and reduce PFJRFs at small knee flexion angles, despite increased peak PFJRF. Additionally, greater decreases in the submaximal PFJRF at 25 degrees of knee flexion were associated with greater decreases in self-reported PFP during single limb landing.