The role of muscle strength &amp; activation patterns in patellofemoral pain

Toumi, Hechmi; Best, Thomas M.; Pinti, Antonio; Lavet, C.; Benhamou, Claude-Laurent; Lespessailles, Éric

doi:10.1016/j.clinbiomech.2013.04.005

Cited by 15 publications

(24 citation statements)

References 15 publications

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“…The results obtained from this investigation indicate that in the clinical setting of LPD, the VMO muscle plays only a subordinate role in the complex interplay between the different stabilizers of the patellofemoral joint. These findings are in agreement with those of recent studies that point to a shift away from the prior tenets that upheld the restoration of quadriceps strength and function as imperative to successful recovery in PFP syndrome [30–32]. Nonetheless, the results of this investigation should be interpreted within the limitations of the study.…”

Section: Discussionsupporting

confidence: 92%

Vastus Medialis Obliquus Muscle Morphology in Primary and Recurrent Lateral Patellar Instability

Balcarek¹,

Oberthür²,

Frosch³

et al. 2014

BioMed Research International

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The morphology of the vastus medialis obliquus (VMO) muscle in the anatomical setting of an unstable patella has not been described. Therefore, the purpose of this study was to investigate the morphological parameters of the VMO muscle that delineate its importance in the maintenance of patellofemoral joint stability. Eighty-two consecutive subjects were prospectively enrolled in this study. The groups were composed of thirty patients with an acute primary patellar dislocation, thirty patients with recurrent patellar dislocation, and twenty-two controls. Groups were adjusted according to sex, age, body mass index, and physical activity. Magnetic resonance imaging was used to measure the VMO cross-sectional area, muscle-fiber angulation, and the craniocaudal extent of the muscle in relation to the patella. No significant difference was found with respect to all measured VMO parameters between primary dislocation, recurrent dislocation, and control subjects with a trend noted for only the VMO cross-sectional area and the VMO muscle-fiber angulation. This finding is notable in that atrophy of the VMO has often been suggested to play an important role in the pathophysiology of an unstable patellofemoral joint.

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Section: Discussionsupporting

confidence: 92%

Vastus Medialis Obliquus Muscle Morphology in Primary and Recurrent Lateral Patellar Instability

Balcarek¹,

Oberthür²,

Frosch³

et al. 2014

BioMed Research International

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“…Functional weight-bearing tasks (WBT) are commonly prescribed in rehabilitation for strengthening of lower extremities, especially the knee muscles 1 ) . Previous studies using electromyography (EMG) have demonstrated that lunge and squat exercises, which are classical examples of WBT, improve joint stabilization and neuromuscular control 2 ) . However, little attention has been given to the influence of real-time feedback on the pattern of muscle activation during WBT.…”

Section: Introductionmentioning

confidence: 99%

Effects of feedback on activation of the quadriceps during weight-bearing tasks of the Wii

et al. 2015

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[Purpose] This investigation evaluated the effect of real-time feedback on electrical activation of the quadriceps during 3 weight-bearing tasks of the Wii Fit Plus®. [Subjects] Thirty male healthy volunteers were recruited. [Methods] Activation of the vastus medialis, vastus lateralis, and rectus femoris muscles was recorded during virtual lunge, single leg extension, and single leg reach exercises. Each exercise was performed twice in 3 randomized experimental conditions (with visual feedback, with auditory feedback, and with no feedback). The normalized electromyographic data (using maximum voluntary isometric contraction) were analyzed using repeated measures analysis of variance and Tukey’s test. [Results] No significant difference was found in the muscles among the feedback conditions during the 3 exercises. However, the variation in the muscle activity of the vastus medialis and vastus lateralis (18.23–29.20% of maximum voluntary isometric contraction) was higher (47–62%) than that in the rectus femoris (7.35–12.98% of maximum voluntary isometric contraction). [Conclusion] Real-time feedback did not alter quadriceps activation during the Wii tasks. Additionally, these games showed electromyographic activation levels similar to those for the same tasks outside the virtual environment. The Wii weight-bearing tasks could therefore constitute a physical activity program but without the additional benefit of feedback.

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“…For instance, Bolgla et al [ 7 ] and Rathleff et al [ 9 ] reported increased amplitude of the EMG activity during stair descent in adults and adolescents with PFP as compared to asymptomatic subjects. On the other hand, decreased amplitude of the EMG activity was found by Møller et al [ 17 ] and Toumi et al [ 18 ] during knee extension efforts. These discrepant findings may be associated with the different nature of the tasks used in the aforementioned studies (e.g.…”

Section: Introductionmentioning

confidence: 84%

Quadriceps neuromuscular function in women with patellofemoral pain: Influences of the type of the task and the level of pain

Briani¹,

Silva²,

Flóride³

et al. 2018

PLoS ONE

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The present study aimed at investigating whether the neuromuscular system behaves differently (in terms of force and muscle activity generation) as a function of the task being performed (i.e. maximal voluntary efforts vs stair negotiation) and the presence of patellofemoral pain (PFP) and possible influences of pain intensity. Thirty-eight women with (n = 19) and without PFP (n = 19) had their knee strength (extension joint torque) measured during maximal voluntary isometric contractions (MVIC) and electromyography (EMG) data recorded during both MVIC and stair ascent tasks, which were performed before and after a loading protocol designed to exacerbate pain symptoms. Women with PFP displayed lower levels of vastus medialis (p = 0.002) and vastus lateralis (p = 0.032) EMG activation during MVIC assessments. Conversely, the PFP group showed higher levels of vastus medialis muscle activity during stair climbing (p = 0.007), which happened exclusively after the loading protocol. Similarly, women with PFP displayed lower knee extensor torque only during the MVIC tests performed after the loading protocol, which was moderately correlated with the increase in self-reported pain (p = 0.041, r = 0.37), whereas the changes in EMG activity during stair ascent were not correlated with changes in pain intensity (p = 0.215, r = 0.12). These results suggest that, in comparison to pain-free controls, women with PFP display lower levels of quadriceps EMG activation during maximal contractions, but higher activation during dynamic tasks (stair ascent). In addition, the moderate association between the decrease in knee extensor torque and increase in self-reported pain indicates that care should be taken by clinicians during quadriceps strength evaluation in women with PFP, as misleading outcomes may emerge if the intensity of knee pain is not considered during screening. Additionally, rehabilitation strategies should focus on both restoring neuromuscular control and increasing muscle strength.

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The role of muscle strength & activation patterns in patellofemoral pain

Cited by 15 publications

References 15 publications

Vastus Medialis Obliquus Muscle Morphology in Primary and Recurrent Lateral Patellar Instability

Vastus Medialis Obliquus Muscle Morphology in Primary and Recurrent Lateral Patellar Instability

Effects of feedback on activation of the quadriceps during weight-bearing tasks of the Wii

Quadriceps neuromuscular function in women with patellofemoral pain: Influences of the type of the task and the level of pain

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