The influence of patellofemoral pain on lower limb loading during gait

Powers, Christopher M.; Heino, Jacklyn G.; Rao, Sreesha; Perry, Jacquelin

doi:10.1016/s0268-0033(99)00019-4

Cited by 98 publications

(92 citation statements)

References 19 publications

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“…Asymmetric gait may be a less metabolically costly strategy for controlling a highly asymmetric system, such as in an individual with the large, physical asymmetries associated with many gait pathologies. Additionally, minimizing metabolic cost is only one possible optimality criteria in human gait; gait asymmetry may be adaptive, for example, by improving impaired balance [39], minimizing joint pain [40] or simplifying control [41]. Indeed, we suspect that asymmetry may be overall optimal in individuals with large physical asymmetries.…”

Section: Discussionmentioning

confidence: 99%

The metabolic and mechanical costs of step time asymmetry in walking

2013

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Animals use both pendular and elastic mechanisms to minimize energy expenditure during terrestrial locomotion. Elastic gaits can be either bilaterally symmetric (e.g. run and trot) or asymmetric (e.g. skip, canter and gallop), yet only symmetric pendular gaits (e.g. walk) are observed in nature. Does minimizing metabolic and mechanical power constrain pendular gaits to temporal symmetry? We measured rates of metabolic energy expenditure and calculated mechanical power production while healthy humans walked symmetrically and asymmetrically at a range of step and stride times. We found that walking with a 42 per cent step time asymmetry required 80 per cent (2.5 W kg 21 ) more metabolic power than preferred symmetric gait. Positive mechanical power production increased by 64 per cent (approx. 0.24 W kg 21 ), paralleling the increases we observed in metabolic power. We found that when walking asymmetrically, subjects absorbed more power during double support than during symmetric walking and compensated by increasing power production during single support. Overall, we identify inherent metabolic and mechanical costs to gait asymmetry and find that symmetry is optimal in healthy human walking.

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Section: Discussionmentioning

confidence: 99%

The metabolic and mechanical costs of step time asymmetry in walking

2013

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“…Typically in human gait studies, individuals who walk more slowly than healthy controls are deemed to have some form of gait disability, but slowing down can simply reflect a 'safer' and more 'tentative' strategy for moving around (Winter, 1989;Powers et al, 1999;Dingwell and Cavanagh, 2001). This assessment of disability is a common subjective view of locomotion in human obesity studies, because obese humans have a similar problem of carrying extra body mass (Messier, 1994;Messier et al, 1996;Browning and Kram, 2009;Spyropoulos et al, 1991).…”

Section: Discussionmentioning

confidence: 99%

The gait dynamics of the modern broiler chicken: A cautionary tale of selective breeding

Paxton

Daley

Corr

et al. 2013

Journal of Experimental Biology

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SUMMARYOne of the most extraordinary results of selective breeding is the modern broiler chicken, whose phenotypic attributes reflect its genetic success. Unfortunately, leg health issues and poor walking ability are prevalent in the broiler population, with the exact aetiopathogenesis unknown. Here we present a biomechanical analysis of the gait dynamics of the modern broiler and its two pureline commercial broiler breeder lines (A and B) in order to clarify how changes in basic morphology are associated with the way these chickens walk. We collected force plate and kinematic data from 25 chickens (market age), over a range of walking speeds, to quantify the three-dimensional dynamics of the centre of mass (CoM) and determine how these birds modulate the force and mechanical work of locomotion. Common features of their gait include extremely slow walking speeds, a wide base of support and large lateral motions of the CoM, which primarily reflect changes to cope with their apparent instability and large body mass. These features allowed the chickens to keep their peak vertical forces low, but resulted in high mediolateral forces, which exceeded fore-aft forces. Gait differences directly related to morphological characteristics also exist. This was particularly evident in Pureline B birds, which have a more crouched limb posture. Mechanical costs of transport were still similar across all lines and were not exceptional when compared with more wild-type ground-running birds. Broiler chickens seem to have an awkward gait, but some aspects of their dynamics show rather surprising similarities to other avian bipeds.

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“…Because the predominant symptom of PFPS is retropatellar pain that increases during weightbearing activities such as running, squatting, and stair climbing, 21,28,43 the diagnosis of PFPS was determined by the complaint of retropatellar pain that was provoked by either a partial squat or stair ascent/ descent. 10,43,54,59 Exclusion criteria included an abnormal neurological status, a recent history of trauma to the knee, ligamentous laxity of the painful knee, palpation tenderness of the joint lines or patellar tendon, or a history of any of the following: prior knee surgery on the symptomatic knee, systemic disease, neurologic disease, or connective tissue disease. Subjects who reported additional lower extremity conditions, such as stress fractures or shin splints, or those already receiving treatment for their knee pain were also excluded.…”

Section: Subjectsmentioning

confidence: 99%

Development of a Clinical Prediction Rule for Classifying Patients With Patellofemoral Pain Syndrome Who Respond to Patellar Taping

Lesher¹,

Sutlive²,

Miller³

et al. 2006

J Orthop Sports Phys Ther

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Study Design: Predictive validity/diagnostic test study. Objective: To determine the predictive validity and interrater reliability of selected clinical exam items and to develop a clinical prediction rule (CPR) to determine which patients respond successfully to patellar taping. Background: Patellar taping is often used to treat patients with PFPS. However, the characteristics of the patients who respond best to patellar taping intervention have not been identified. Methods and Measures: Fifty volunteers (27 males, 23 females) with PFPS underwent a standardized clinical examination. Diagnosis of PFPS was based on the complaint of retropatellar pain that was provoked by a partial squat or stair ascent/descent. Subjects performed 3 functional activities and rated their pain during each activity on a numerical rating scale (NPRS). All subjects received treatment with a medial glide patellar-taping technique and repeated the functional activities and pain ratings. An immediate 50% reduction in pain or moderate improvement on a global rating of change (GRC) questionnaire was considered a treatment success. Likelihood ratios (LRs) were calculated to determine which examination items were most predictive of treatment outcome. Logistic regression analysis identified items included in the CPR. Results: Twenty-six subjects (52%) had an immediate successful response to the intervention. Two examination items (positive patellar tilt test or tibial varum greater than 5°, +LR = 4.4) comprised the CPR. Application of the CPR improved the probability of a successful outcome from 52% to 83%. Fifty-eight percent of the lower extremity measures were associated with moderate to good reliability (reliability coefficient range, 0.52-0.84). The reliability coefficients for the items that comprised the CPR were 0.49 (patellar tilt) and 0.66 (tibial varum). Thomas G. Sutlive, 3151 Scott Road Suite 1230, Fort Sam Houston, TX 78234. E-mail: thomas.sutlive@cen.amedd.army.mil Conclusion: A CPR was developed to predict an immediate successful response to a medial glide patellar taping technique. Validation of the CPR in an independent sample is necessary before widespread clinical use can be recommended.

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The influence of patellofemoral pain on lower limb loading during gait

Cited by 98 publications

References 19 publications

The metabolic and mechanical costs of step time asymmetry in walking

The metabolic and mechanical costs of step time asymmetry in walking

The gait dynamics of the modern broiler chicken: A cautionary tale of selective breeding

Development of a Clinical Prediction Rule for Classifying Patients With Patellofemoral Pain Syndrome Who Respond to Patellar Taping

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