The quadriceps function in patellofemoral disorders

Møller, Bjarne Nue; Jurik, Anne Grethe; Tidemand-Dal, C.; Krebs, B.; Aaris, K.

doi:10.1007/bf00452210

Cited by 23 publications

(13 citation statements)

References 12 publications

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“…Strengthening of the vastus medialis obliquus muscle is considered one of the essential components of the nonoperative approach to patellofemoral pain. 16,34,38,40,43,52,53 Recent studies have concluded that not only the strength of this muscle but also the time to activation is disturbed in patients with patellofemoral pain. 60,65 These studies have also shown that the activation pattern of the vastus medialis obliquus and vastus lateralis muscles is disturbed in patients with patellofemoral pain.…”

Section: Discussionmentioning

confidence: 99%

Intrinsic Risk Factors for the Development of Anterior Knee Pain in an Athletic Population: A Two-Year Prospective Study

et al. 2000

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Many variables have retrospectively been associated with the presence of anterior knee pain. Very few prospective data exist, however, to determine which of these variables will lead to the development of anterior knee pain. It was our purpose in this study to determine the intrinsic risk factors for the development of anterior knee pain in an athletic population over a 2-year period. Before the start of training, 282 male and female students enrolled in physical education classes were evaluated for anthropometric variables, motor performance, general joint laxity, lower leg alignment characteristics, muscle length and strength, static and dynamic patellofemoral characteristics, and psychological parameters. During this 2-year follow-up study, 24 of the 282 students developed patellofemoral pain. Statistical analyses revealed a significant difference between those subjects who developed patellofemoral pain and those who did not concerning quadriceps and gastrocnemius muscle flexibility, explosive strength, thumb-forearm mobility, reflex response time of the vastus medialis obliquus and vastus lateralis muscles, and the psychological parameter of seeking social support. However, only a shortened quadriceps muscle, an altered vastus medialis obliquus muscle reflex response time, a decreased explosive strength, and a hypermobile patella had a significant correlation with the incidence of patellofemoral pain. We concluded that the latter four parameters play a dominant role in the genesis of anterior knee pain and we therefore deem them to be risk factors for this syndrome.

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Section: Discussionmentioning

confidence: 99%

Intrinsic Risk Factors for the Development of Anterior Knee Pain in an Athletic Population: A Two-Year Prospective Study

et al. 2000

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“…16,34,38,40,43,52,53 Recent studies have concluded that not only the strength of this muscle but also the time to activation is disturbed in patients with patellofemoral pain. 60,65 These studies have also shown that the activation pattern of the vastus medialis obliquus and vastus lateralis muscles is disturbed in patients with patellofemoral pain.…”

Section: Discussionmentioning

confidence: 99%

Intrinsic Risk Factors for the Development of Patellar Tendinitis in an Athletic Population

et al. 2001

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Retrospective studies have suggested various factors that might cause a disposition to develop patellar tendinitis, but no prospective data exist to determine any relationships. The purpose of this study was to determine the intrinsic risk factors for the development of patellar tendinitis in an athletic population. Before the study, 138 male and female students of physical education were evaluated for anthropometric variables, leg alignment characteristics, and muscle tightness and strength parameters. During the 2-year study, 19 of the 138 students developed patellar tendinitis. In all cases the diagnosis was confirmed by the presence of a hypoechogenic nodular lesion in the proximal region of the patellar tendon. Univariate and stepwise discriminant function analyses were performed comparing the various measurements. These analyses revealed that the only significant determining factor was muscular flexibility, with the patellar tendinitis patients being less flexible in the quadriceps and hamstring muscles (P < 0.05). The results of this study demonstrate that lower flexibility of the quadriceps and hamstring muscles may contribute to the development of patellar tendinitis in an athletic population. Therefore, the prevention of this condition in athletes should be focused on screening for and treating poor quadriceps and hamstring muscle flexibility.

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“…Two among several EMG studies attempted to investigate patellar location changes resulting from quadriceps contraction [16,27], but both of them utilized conventional imaging techniques under static conditions. There are several studies focused on the relative activity of quadriceps components under different contraction patterns and exercises [4,12,19,32,34,40].…”

Section: Discussionmentioning

confidence: 99%

“…and balanced activity between these two muscles is considered desirable to maintain normal patellofemoral tracking [4,12,19,32,34]. VMO weakness in patellofemoral pain syndrome, patellar instability and effused knees in which imbalanced activity of the VMO and VL has been demonstrated has been noted by several authors [4,18,23,27,[34][35][36]40]. Treatment regimens on the basis of selective strengthening of VMO have had some successful results, but there is still no consensus on whether these contraction patterns also restore the patellofemoral malalignment [16,21,31,38].…”

mentioning

confidence: 99%

“…Because of the above-mentioned difficulties, many authors have attempted to record and quantify the relative activities of quadriceps muscle components using electromyography (EMG) [4,23,[26][27][28]34]. It has been shown that EMG is a valid tool in the measurement of isometric muscle contraction [33,40], and the records obtained with surface electrodes can give sufficient information [5].…”

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confidence: 99%

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Effect of the vastus medialis obliquus on the patellofemoral joint

Taşkıran¹,

Dinedurga²,

Yağiz

et al. 1998

Knee Surgery, Sports Traumatology, Arthroscopy

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In this study, the effect of dynamic stabilizers on the patellofemoral (PF) joint was investigated in normal volunteers (group I) and in patients with patellar pain (group II) or instability (group III) by using computed tomography (CT) analysis and integrated electromyography (iEMG) of the quadriceps muscle. Nine subjects (16 knees) from group I, 10 patients (12 knees) from group II and 8 patients (12 knees) from group III were included in the study. CT scans of the PF joint with quadriceps contracted (QC) and uncontracted (QU) and iEMG of vastus medialis obliquus (VMO), vastus lateralis (VL) and rectus femoris (RF) were obtained with the aid of a specially designed jig at 0 degree, 15 degrees, 30 degrees and 45 degrees of knee flexion. The same muscle contraction pattern simulating closed kinetic chain exercise was used for both CT and iEMG. The difference between the congruence angles (CA) and tilt angles (PTA) in QC and QU positions and VMO:VL ratio from the iEMG were calculated separately for each flexion angle. CA was increased in all groups with quadriceps contraction at 0 degree and 15 degrees of flexion. PTA was decreased in group I and increased in groups II and III with quadriceps contraction at the same flexion angles. This difference was statistically significant in group III at 0 degree and 15 degrees of flexion. Quadriceps contraction did not affect the patellar position significantly even in the instability group at 45 degrees of flexion. In all flexion angles the balanced VMO:VL activity ratio was observed only in group I. In the other groups, VL activity was higher than VMO activity except at 45 degrees of flexion. These findings do not support the hypothesis of dominant centralizing effect of VMO on the patella in extension, but the effect of the VMO may be more clearly demonstrated by measuring PTA in both QC and QU positions.

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The quadriceps function in patellofemoral disorders

Cited by 23 publications

References 12 publications

Intrinsic Risk Factors for the Development of Anterior Knee Pain in an Athletic Population: A Two-Year Prospective Study

Intrinsic Risk Factors for the Development of Anterior Knee Pain in an Athletic Population: A Two-Year Prospective Study

Intrinsic Risk Factors for the Development of Patellar Tendinitis in an Athletic Population

Effect of the vastus medialis obliquus on the patellofemoral joint

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