Abstract
Objective. To determine knee angular velocity changes during stair descent and slow velocity
eccentric isokinetic quadriceps contraction, in normal controls and patellofemoral
pain syndrome patients.
Design. Isokinetic and kinematic analysis of the performance of patellofemoral pain syndrome
patients and matched normal controls.
Background. In the presence of increased patellofemoral joint stresses, patellofemoral pain syndrome
patients have been shown to adopt compensatory strategies to minimise joint loading
and therefore pain. One of the compensatory strategies reported, is that of the break
phenomena, which results in a change quadriceps torque production.
Methods. Twenty female patients with patellofemoral pain syndrome and 20 asymptomatic matched
controls participated in the study. All subjects had their isokinetic eccentric and
concentric quadriceps torque assessed at 30 degrees/second and 2-dimensional video
data taken when descending from a step. Variations in knee angular velocity and torque
curves were then identified.
Results. None of the subjects demonstrated a break on isokinetic concentric quadriceps contraction.
Of the patellofemoral pain syndrome patients, 50% (10 out of 20) had a break in eccentric
torque curve on testing, compared with 15% (3 out of 20) of the controls. Abnormal
curve perturbation was demonstrated to occur in none of the controls isokinetically,
but 20% (4 out 20) of the patellofemoral pain syndrome patients had perturbations
in their torque curves. On stair decent a break was seen in 60% (12 out of 20) of
the patellofemoral pain syndrome patients and 15% (3 out of 20) of the control subjects
on analysis of the knee angular velocity. Twenty percent (4 out of 20) of the patellofemoral
pain syndrome patients and 10% (2 out of 20) of the controls had abnormal curve perturbation
on analysis of their stair descent.
Conclusions. The implications are that there appears to be a relationship between patellofemoral
pain syndrome and control of eccentric quadriceps contraction. This relationship is
possibly related to joint and soft tissue loading not just the degree of pain, with
the break being a saving reflex to prevent further stress.
Relevance Exercise to rehabilitate the quadriceps in patellofemoral pain syndrome should be
chosen with regard to joint loading and range of movement as well as velocity of contraction,
in order to facilitate quadriceps activation as opposed to inhibiting it.
Keywords
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Article info
Publication history
Accepted:
March 13,
2003
Received:
September 20,
2002
Identification
Copyright
© 2003 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
