A clinical study of the biomechanics of step descent using different treatment modalities for patellofemoral pain

Selfe, James; Thewlis, Dominic; Hill, Samantha; Whitaker, Jonathan; Sutton, Chris J; Richards, Jim

doi:10.1016/j.gaitpost.2011.03.019

Cited by 39 publications

(44 citation statements)

References 26 publications

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“…This implies there is a change in movement strategy when wearing the brace applied away from valgus internal rotation or "dynamic valgus position of the knee" which has been shown to be an important risk factor for ACL injury [7,23]. No significant reduction of range of motion in the coronal plane was seen during the slow step down task however a similar study (Selfe et al, 2008) [2] found a reduction in the range of motion for this task, however the brace did reduce internal rotation of the knee in the transverse plane which is in agreement with Selfe et al (2011) [3].…”

Section: Discussionsupporting

confidence: 66%

“…Khadavi et al [1] showed that the Reaction Brace reduces knee pain, increase function and enhance quality of life with individuals with patellofemoral pain. Selfe et al [2,3] have previously shown on healthy participants and patients with patellofemoral pain that taping and soft and flexible braces can offer an improvement in movement control in the coronal and transverse planes. This may partially be explained by Edin [4] who stated that the stabilizing effects of taping techniques may be due to altered somatosensory inflow from the knee joint.…”

Section: Introductionmentioning

confidence: 99%

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The effect of proprioceptive knee bracing on knee stability during three different sport related movement tasks in healthy subjects and the implications to the management of Anterior Cruciate Ligament (ACL) injuries

et al. 2016

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(2016) The effect of proprioceptive knee bracing on knee stability during three different sport related movement tasks in healthy subjects and the implications to the management of Anterior Cruciate Ligament (ACL) injuries. Gait and Posture, 48 . pp. 165 170. ISSN 0966 6362 It is advisable to refer to the publisher's version if you intend to cite from the work. Objective: This study aimed to explore if such improvements in stability may be seen during faster sports specific tasks as well as slower tasks. Method: Twelve subjects performed a slow step down, single leg drop jump and pivot turn jump with and without a silicone web brace. 3D kinematics of the knee were collected using a ten camera Qualisys motion analysis system. Reflective markers were placed on the foot, shank, thigh and pelvis using the Calibrated Anatomical Systems Technique. A two way ANOVA with repeated measures was performed with post-hoc pairwise comparison to explore the differences between the two conditions and three tasks. Results: Significant differences were seen in the knee joint angles and angular velocities in the sagittal, coronal and transverse planes between the tasks. The brace showed a reduction in knee valgum and internal rotation across all tasks, with the most notable effect during the single leg drop jump and pivot turn jump. The transverse plane also showed a significant reduction in the external rotation knee angular velocity when wearing the brace. Discussion: The brace influenced the knee joint kinematics in coronal and transverse planes which confirms that such braces can have a significant effect on knee control during dynamic tasks. Further studies are required exploring the efficacy of proprioceptive braces in athletic patient cohort. Acknowledgements This study is partly founded by Erasmus+ program who have sponsored two masters students. The braces were supplied by DJO Global, Inc. The suppliers played no role in the design, execution, analysis and interpretation of the data or writing of this study.2

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Section: Discussionsupporting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

The effect of proprioceptive knee bracing on knee stability during three different sport related movement tasks in healthy subjects and the implications to the management of Anterior Cruciate Ligament (ACL) injuries

et al. 2016

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“…Nonetheless the reduction in transverse plane internal/external range of motion ties in with the subjective ratings which showed that participants found that the knee brace improved perceived stability in all movements. Selfe et al (2011) proposed that cutaneous stimulation provided by the brace may be a factor in enhancing neuromotor control. Because knee bracing apply pressure to the supporting structures surrounding the knee Selfe et al (2011) proposed that pressure applied specifically at the posterior of the knee may have a stimulatory influence on the hamstring and gastrocnemius muscles which contributed to increased stability and control.…”

Section: Discussionmentioning

confidence: 99%

“…Selfe et al (2011) proposed that cutaneous stimulation provided by the brace may be a factor in enhancing neuromotor control. Because knee bracing apply pressure to the supporting structures surrounding the knee Selfe et al (2011) proposed that pressure applied specifically at the posterior of the knee may have a stimulatory influence on the hamstring and gastrocnemius muscles which contributed to increased stability and control. A potential limitation to this work is that patellofemoral PTCF and PTS were obtained using a musculoskeletal driven model.…”

Section: Discussionmentioning

confidence: 99%

Effects of prophylactic knee bracing on knee joint kinetics and kinematics during netball specific movements

Sinclair

Vincent

Richards

2017

Physical Therapy in Sport

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ObjectiveTo investigate the effects of a prophylactic knee brace on knee joint kinetics and kinematics in netball specific movements. DesignRepeated measures; Setting: Laboratory; Participants: Twenty university first team level female netball players. Outcome measurementsParticipants performed three movements, run, cut and vertical jump under two conditions (brace and no-brace). 3-D knee joint kinetics and kinematics were measured using an eight-camera motion analysis system. Knee joint kinetics and kinematics were examined using 2 × 3 repeated measures ANOVA whilst the subjective ratings of comfort and stability were investigated using chi-squared tests. ResultsThe results showed no differences (p > 0.05) in knee joint kinetics. However the internal/external rotation range of motion was significantly (p < 0.05) reduced when wearing the brace in all movements. The subjective ratings of stability revealed that netballers felt that the knee brace improved knee stability in all movements. ConclusionsFurther study is required to determine whether reductions in transverse plane knee range of motion serve to attenuate the risk from injury in netballers.

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“…Powers et al [25] analyzed an orthosis that applied a medially directed force on the patella in PFPS patients and reported decreased pain and increased activation of the quadriceps. Selfe et al [26,27] investigated the effect of patellar bracing and taping on the three-dimensional mechanics of the knee during a controlled step-down task in healthy and PFPS patients. These studies showed that bracing and taping offered coronal-plane and torsional control of the patella during eccentric contraction of the quadriceps in both PFPS patients and healthy subjects [26-29].…”

Section: Introductionmentioning

confidence: 99%

The Patella Pro study — effect of a knee brace on patellofemoral pain syndrome: design of a randomized clinical trial (DRKS-ID:DRKS00003291)

Petersen

Ellermann

Rembitzki

et al. 2014

BMC Musculoskelet Disord

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BackgroundPatellofemoral pain syndrome (PFPS) is a frequent cause of anterior knee pain predominantly affecting young female patients who do not have significant chondral damage. Development of PFPS is probably multifactorial, involving various knee, hip, and foot kinematic factors. Biomechanical studies have described patellar maltracking and dynamic valgus (functional malalignment) in patients with patellofemoral pain syndrome. The literature provides evidence for short-term use of nonsteroidal anti-inflammatory drugs; short-term medially directed taping; and exercise programs focusing on the lower extremity, hip, and trunk muscles. Evidence supporting the use of patellar braces is limited because previous studies have been low quality. The aim of this article is to publish the design of a prospective randomized trial that examines the outcomes of patients with PFPS after treatment with a new patellar brace (Patella Pro) that applies medially directed force on the patella.Methods/DesignFor this multicenter trial, 156 patients (adolescents and young adults) with PFPS were recruited from orthopedic practices and orthopedic hospitals and randomly allocated to 3 months of supervised physiotherapy in combination with the Patella Pro brace or supervised physiotherapy alone. The primary outcome measures are pain (numerical analog scale); knee function (Kujala score and Knee Injury and Osteoarthritis Outcome Score); and self-reported perception of recovery at baseline, 6 weeks, 3 months, and 1 year.DiscussionOnly limited evidence for the use of a patellar brace for the treatment of PFPS exists in the literature. Disputable evidence for the use of orthoses for PFPS patients has been presented in one meta-analysis, in which only one of three studies found the effect of a medially directed patellar brace to be significant. Because of these low-quality studies, the authors concluded that this evidence should be regarded as limited, and we feel there is a need for further well-designed studies to evaluate the effect of patellar bracing on PFPS-related pain. The Patella Pro study is a prospective randomized trial in which supervised physiotherapy in combination with a patellar brace is compared with supervised physiotherapy alone. This trial started in April 2012 and finished in October 2013.Trial registrationDRKS-ID:DRKS00003291, January 3rd, 2012

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A clinical study of the biomechanics of step descent using different treatment modalities for patellofemoral pain

Cited by 39 publications

References 26 publications

The effect of proprioceptive knee bracing on knee stability during three different sport related movement tasks in healthy subjects and the implications to the management of Anterior Cruciate Ligament (ACL) injuries

The effect of proprioceptive knee bracing on knee stability during three different sport related movement tasks in healthy subjects and the implications to the management of Anterior Cruciate Ligament (ACL) injuries

Effects of prophylactic knee bracing on knee joint kinetics and kinematics during netball specific movements

The Patella Pro study — effect of a knee brace on patellofemoral pain syndrome: design of a randomized clinical trial (DRKS-ID:DRKS00003291)

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