Quadriceps architecture in individuals with patellofemoral pain: A systematic review

Ashnagar, Zinat; Hadian, Mohammad-Reza; Sajjadi, Elaheh; Kajbafvala, Mehrnaz; Olyaei, Gholamreza; Pashazadeh, Fariba; Rezasoltani, Asghar

doi:10.1016/j.jbmt.2020.08.007

Cited by 3 publications

(6 citation statements)

References 22 publications

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“…The measurements of the muscular architecture acquired in this investigation are in good agreement with measurements of the quadriceps muscle assessed in earlier studies using ultrasonography [ 4 ]. The mean CSA of VM for the group A was (15.26+2.33), group B was (15.98+2.55), group C was (16.09+2.8) and group D was (13.94+2.7) which is coinciding with Minnehan et al [ 13 ].…”

Section: Discussionsupporting

confidence: 87%

“…The thickness, cross-sectional area (CSA), fascicle length (FL) and pennation angle or fibre angle (PA) of a muscle are important factors in the creation of force and the operation of the muscle during bodily motions. A typical side effect of knee diseases is quadriceps weakness, which can be brought on by both muscle atrophy and neural inhibition, which inhibits the muscle from fully activating [ 4 ]. Quadriceps atrophy and morphological alteration is a documented phenomenon that can have a major impact on strength and functional performance of PFPS patients.…”

Section: Introductionmentioning

confidence: 99%

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Physiotherapeutic interventions on quadriceps muscle architecture in patello-femoral pain syndrome

Krishnan

2023

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Quadriceps weakness and morphological alteration is a documented phenomenon that can have a major impact on strength and functional performance of PFPS patients. An effective and trustworthy non-invasive technique for measuring the quadriceps muscle's anatomy and architecture is B- Mode Ultrasonography. The aim of the study is to assess & compare the effectiveness of neuromuscular electrical stimulation application, quadriceps strengthening & in combination on the quadriceps muscle architecture and functional capacity in patients with Patello femoral pain syndrome. One hundred and twenty-four participants aged 18 - 40 years old with anterior knee pain were included. Participants were randomly allocated into four groups. Group A participants were given NMES, group B were given QS, group C were given combination therapy (NMES+QS) and group D was control group. Cross sectional area, Fascicle length & pennation angle were measured using B-Mode (2D) ultrasound for Quadriceps Femoris muscle. Knee function & pain were assessed using Kujala score and VAS. All parameters were evaluated before and after the intervention. The mean age, weight, height & BMI of control, NMES, QS and NMES+QS were not statistically significant (P = 0.881, 0.960, 0.951 & 0.953) which shows that the control and experimental groups were homogenous. Combination group showed significant improvement when compared to QS group followed by NMES group. Control group did not show any improvement. Neuromuscular Electrical Stimulation in combination with quadriceps strengthening showed a better outcome than in isolation on quadriceps muscle architecture after 10 weeks.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Physiotherapeutic interventions on quadriceps muscle architecture in patello-femoral pain syndrome

Krishnan

2023

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“…Large FAA could cause the internal rotation of the distal femur and was reported related to the PFPS [12][13][14] . It had been reported in previous studies that the VMO was atrophied in patients with PFPS [20][21][22] . However, due to the complex etiologies of patellofemoral instability, including congenital force line and bone structure factors, as well as acquired factors such as muscles and ligaments, we believed that one of the important reasons was the increase of FAA.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies had shown that the VMO was atrophied in patients with patellofemoral pain syndrome (PFPS) [20][21][22] . The researchers supposed that the VMO may disuse atrophy.…”

Section: Introductionmentioning

confidence: 99%

The Vastus Medialis Oblique Compensates in Current Patellar Dislocation Patients with The Increased Femoral Anteversion

Dong

Zhao

Wang

2021

Preprint

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Purpose The purpose of this study was to investigate whether the vastus medialis oblique (VMO) compensates in patella dislocation patients with the increase of femoral anteversion angle (FAA).Methods From January 2016 to January 2021, a total of 30 knees of 27 patients with recurrent patellar dislocation (RPD Group) were reviewed for this study. Among these patients, 13 patients with patellar dislocation and excessive FAA, >30° were assigned to A Group, and 17 patients with the patellar dislocation without excessive FAA,≤30 were assigned to B Group. And 27 age and sex matched knees without patellofemoral disorders were enrolled as control (C Group). The area of the VMO and vastus lateralis muscle (VLM) was measured 20 mm above the upper edge of the patella, and the ratio of the VMO and VLM area was calculated. The correlation relationship of FAA and VMO, VLM was analyzed.Results Comparing with the C Group, the RPD Group had a significantly larger FAA (30.10± 9.61°vs 15.00± 1.85°, P< 0.05), and smaller VMO/VLM ratio (3.49±1.00/4.18±1.51, P< 0.05), and the VMO/VLM ratio was significantly greater in A Group than the B Group (3.97±1.11 vs3.12±0.70, P< 0.05). There was no statistically significant difference in VMO/VLM ratio among A Group and C Group (3.12±0.70/3.97±1.11, P> 0.05). And the VMO/VLM ratio was decreased in the B Group compared with the C Group (3.12±0.70/4.18±1.51, P< 0.05). The VMO/VLM ratio was positively correlated with the FAA(r=0.42) in the RPD Group.Conclusion Compared with the C Group, the patients with recurrent patellar dislocation had a smaller VMO/VLM ratio. Moreover, the FAA was positively correlated with the VMO/VLM in patients with patella dislocation. This finding explained the compensatory thickening of the VMO in response to excessive FAA in patients with patella dislocation.

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“…The VM and VL PCSA and moment arms also did not differ between groups, which match findings in adults. 4,13,42 The absence of differences between groups cannot discount that other mechanical factors may contribute to adolescent-onset patellofemoral pain, since other biomechanical parameters may contribute significantly to healthy patellar tracking (reviewed previously 3 ). For example, it is possible that joint geometry (eg, patella alta, trochlear groove depth 38 ) or tendon properties are different between groups.…”

Section: Discussionmentioning

confidence: 99%

Neuromechanical Properties of the Vastus Medialis and Vastus Lateralis in Adolescents With Patellofemoral Pain

Crouzier

Hug

Sheehan

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: An alteration in the force distribution among quadriceps heads is one possible underlying mechanism of patellofemoral pain. However, this hypothesis cannot be directly tested as there are currently no noninvasive experimental techniques to measure individual muscle force or torque in vivo in humans. In this study, the authors considered a combination of biomechanical and muscle activation measures, which enabled us to estimate the mechanical impact of the vastus medialis (VM) and vastus lateralis (VL) on the patella. Purpose/Hypothesis: The purpose of this study was to determine whether the relative index of torque distribution for the VM and VL differs between adolescents with and without patellofemoral pain. It was hypothesized that, relative to the VL, the VM would contribute less to knee extension torque in adolescents with patellofemoral pain compared with controls. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Twenty adolescents with patellofemoral pain and 20 matched control participants were included (38 female; age, 15.3 ± 1.8 years; weight, 58 ± 13 kg; height, 164 ± 8 cm). Muscle volumes and resting moment arms were quantified from magnetic resonance images, and fascicle lengths were obtained from panoramic B-mode ultrasonography. Muscle activation was estimated using surface electromyography during submaximal isometric tasks (wall-squat and seated tasks). Muscle torque was estimated as the product of muscle physiological cross-sectional area (ie, muscle volume/fascicle length), muscle activation (normalized to maximal activation), and moment arm. Results: Across tasks and force levels, the relative contribution of the VM to the overall medial and lateral vastii torque was 31.0% ± 8.6% for controls and 31.5 ± 7.6% for adolescents with patellofemoral pain (group effect, P > .34). Conclusion: For the tasks and positions investigated in this study, the authors found no evidence of lower VM torque generation (relative to the VL) in adolescents with patellofemoral pain compared with controls.

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Quadriceps architecture in individuals with patellofemoral pain: A systematic review

Cited by 3 publications

References 22 publications

Physiotherapeutic interventions on quadriceps muscle architecture in patello-femoral pain syndrome

Physiotherapeutic interventions on quadriceps muscle architecture in patello-femoral pain syndrome

The Vastus Medialis Oblique Compensates in Current Patellar Dislocation Patients with The Increased Femoral Anteversion

Neuromechanical Properties of the Vastus Medialis and Vastus Lateralis in Adolescents With Patellofemoral Pain

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