Propulsion Phase of the Single Leg Triple Hop Test in Women with Patellofemoral Pain Syndrome: A Biomechanical Study

Abstract

Asymmetry in the alignment of the lower limbs during weight-bearing activities is associated with patellofemoral pain syndrome (PFPS), caused by an increase in patellofemoral (PF) joint stress. High neuromuscular demands are placed on the lower limb during the propulsion phase of the single leg triple hop test (SLTHT), which may influence biomechanical behavior. The aim of the present cross-sectional study was to compare kinematic, kinetic and muscle activity in the trunk and lower limb during propulsion in the SLTHT using women with PFPS and pain free controls. The following measurements were made using 20 women with PFPS and 20 controls during propulsion in the SLTHT: kinematics of the trunk, pelvis, hip, and knee; kinetics of the hip, knee and ankle; and muscle activation of the gluteus maximus (GM), gluteus medius (GMed), biceps femoris (BF) and vastus lateralis (VL). Differences between groups were calculated using three separate sets of multivariate analysis of variance for kinematics, kinetics, and electromyographic data. Women with PFPS exhibited ipsilateral trunk lean; greater trunk flexion; greater contralateral pelvic drop; greater hip adduction and internal rotation; greater ankle pronation; greater internal hip abductor and ankle supinator moments; lower internal hip, knee and ankle extensor moments; and greater GM, GMed, BL, and VL muscle activity. The results of the present study are related to abnormal movement patterns in women with PFPS. We speculated that these findings constitute strategies to control a deficient dynamic alignment of the trunk and lower limb and to avoid PF pain. However, the greater BF and VL activity and the extensor pattern found for the hip, knee, and ankle of women with PFPS may contribute to increased PF stress.

Correlation of Lower Limb Strength, Power, Waist-Hip Ratio and Bmi With a Sitting-Rising Test in 18-35 Years Age Group

“…Power of lower extremities was assessed using triple hop test with the dominant leg. This test is previously used in studies conducted on athletes, patients with an anterior cruciate ligament injury and reconstruction [14], and in women with patellofemoral pain [19]. Triple hop has two basic phases viz.…”

Quality Assurance Study on (Physio)therapy According To the Spiraldynamik® Concept for Treating Patients with Knee Complaints

“…In patients suffering from PFPS, conspicuous coordination patterns can be measured during the weight-bearing phase, e.g. pronounced contralateral pelvis drop, reduced strength in the hip abductors, also showing higher EMG activity levels, deviation in the knock-kneed alignment with higher internal rotation in the hip and weakness of the external rotators, pronounced external rotation of the tibia with high EMG activity in the biceps femoris and vastus lateralis and pes valgus [13][14][15]. Muscle weakness in the external rotators and abductors of the hip may be related to the pronounced hip adduction and internal rotation during the weight-bearing phase [14].…”

“…pronounced contralateral pelvis drop, reduced strength in the hip abductors, also showing higher EMG activity levels, deviation in the knock-kneed alignment with higher internal rotation in the hip and weakness of the external rotators, pronounced external rotation of the tibia with high EMG activity in the biceps femoris and vastus lateralis and pes valgus [13][14][15]. Muscle weakness in the external rotators and abductors of the hip may be related to the pronounced hip adduction and internal rotation during the weight-bearing phase [14]. Focused training of external rotators and abductors of the hip may reduce the pain -however, there is no effect on the movement patterns during running [12,16].…”

Does low back pain or leg pain in gluteus medius syndrome contribute to lumbar degenerative disease and hip osteoarthritis and vice versa? A literature review

“…Bley AS et al 149) Female patients with PFPS PFPS group generated significantly greater EMG activity of GMed and greater hip abd. moment than controls Izumi M et al 150) Hypertonic saline injection GMed PPT was increased Rutherford DJ et al 151) Patients with moderate knee OA (n=54) No clear relationship of hip abd.…”