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Reliability and differentiation capability of dynamic and static kinematic measurements of rearfoot eversion in patellofemoral pain

      Highlights

      • We present a new approach of rearfoot eversion in patellofemoral pain.
      • Dynamic kinematic rearfoot eversion demonstrated the highest diagnostic accuracy.
      • Static variables do not seem to be related to PFP and have low accuracy values.
      • Rearfoot eversion clinical test has low to moderate values of reliability.
      • Rearfoot eversion alterations seem to appear during challenging dynamic conditions.

      Abstract

      Background

      Excessive rearfoot eversion is thought to be a risk factor for patellofemoral pain development, due to the kinesiological relationship with ascendant adaptations. Individuals with patellofemoral pain are often diagnosed through static clinical tests, in scientific studies and clinical practice. However, the adaptations seem to appear in dynamic conditions. Performing static vs. dynamic evaluations of widely used measures would add to the knowledge in this area. Thus, the aim of this study was to determine the reliability and differentiation capability of three rearfoot eversion measures: rearfoot range of motion, static clinical test and static measurement using a three-dimensional system.

      Method

      A total of 29 individuals with patellofemoral pain and 25 control individuals (18–30 years) participated in this study. Each subject underwent three-dimensional motion analysis during stair climbing and static clinical tests. Intraclass correlation coefficient and standard error measurements were performed to verify the reliability of the variables and receiver operating characteristic curves to show the diagnostic accuracy of each variable. In addition, analyses of variance were performed to identify differences between groups.

      Findings

      Rearfoot range of motion demonstrated higher diagnostic accuracy (an area under the curve score of 0.72) than static measures and was able to differentiate the groups. Only the static clinical test presented poor and moderate reliability. Other variables presented high to very high values.

      Interpretation

      Rearfoot range of motion was the variable that presented the best results in terms of reliability and differentiation capability. Static variables do not seem to be related to patellofemoral pain and have low accuracy values.

      Keywords

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      References

        • Aliberti S.
        • Costa M.S.X.
        • Passaro A.C.
        • Arnone A.C.
        • Sacco I.C.N.
        Medial contact and smaller plantar loads characterize individuals with patellofemoral pain syndrome during stair descent.
        Phys. Ther. Sport. 2010; 11: 30-34
        • Aliberti S.
        • Costa M.D.S.
        • Passaro A.D.C.
        • Arnone A.C.
        • Hirata R.
        • Sacco I.C.N.
        Influence of patellofemoral pain syndrome on plantar pressure in the foot rollover process during gait.
        Clin. Sci. 2011; 66: 367-372
        • Baldon R.D.M.
        • Serrão F.V.
        • Silva R.S.
        • Piva S.R.
        Effects of functional stabilization training on pain, function, and lower extremity biomechanics in women with patellofemoral pain: a randomized clinical trial.
        J. Orthop. Sports Phys. Ther. 2014; 44: 240-A8
        • Barton C.J.
        • Levinger P.
        • Menz H.B.
        • Webster K.E.
        Kinematic gait characteristics associated with patellofemoral pain syndrome: a systematic review.
        Gait Posture. 2009; 30: 405-416
        • Barton C.J.
        • Menz H.B.
        • Levinger P.
        • Webster K.E.
        • Crossley K.M.
        Greater peak rearfoot eversion predicts foot orthoses efficacy in individuals with patellofemoral pain syndrome.
        Br. J. Sports Med. 2011; 45: 697-701
        • Barton C.J.
        • Levinger P.
        • Crossley K.M.
        • Webster K.E.
        • Menz H.B.
        Relationships between the foot posture index and foot kinematics during gait in individuals with and without patellofemoral pain syndrome.
        J. Foot Ankle Res. 2011; 4: 10
        • Barton C.J.
        • Levinger P.
        • Webster K.E.
        • Menz H.B.
        Walking kinematics in individuals with patellofemoral pain syndrome: a case–control study.
        Gait Posture. 2011; 33: 286-291
        • Barton C.J.
        • Levinger P.
        • Crossley K.M.
        • Webster K.E.
        • Menz H.B.
        The relationship between rearfoot, tibial and hip kinematics in individuals with patellofemoral pain syndrome.
        Clin. Biomech. 2012; 27: 702-705
        • Collado H.
        • Fredericson M.
        Patellofemoral pain syndrome.
        Clin. Sports Med. 2010; 29: 379-398
        • Collins N.
        • Crossley K.
        • Beller E.
        • Darnell R.
        • McPoil T.
        • Vicenzino B.
        Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial.
        Br. J. Sports Med. 2009; 43: 169-171
        • Ferrari D.
        • Kuriki H.U.
        • Silva C.R.
        • Alves N.
        • Mícolis de Azevedo F.
        Diagnostic accuracy of the electromyography parameters associated with anterior knee pain in the diagnosis of patellofemoral pain syndrome.
        Arch. Phys. Med. Rehabil. 2014; 95: 1521-1526
        • Freedman B.R.
        • Sheehan F.T.
        Predicting three-dimensional patellofemoral kinematics from static imaging-based alignment measures.
        J. Orthop. Res. 2013; 31: 441-447
        • Halabchi F.
        • Mazaheri R.
        • Seif-barghi T.
        Patellofemoral pain syndrome and modifiable intrinsic risk factors; how to assess and address?.
        Asian J. Sports Med. 2013; 4: 85-100
        • Houck J.R.
        • Tome J.M.
        • Nawoczenski D.A.
        Subtalar neutral position as an offset for a kinematic model of the foot during walking.
        Gait Posture. 2008; 28: 29-37
        • Kadaba M.P.
        • Ramakrishnan H.K.
        • Wootten M.E.
        Measurement of lower extremity kinematics during level walking.
        J. Orthop. Res. 1990; 8: 383-392
        • Kellis E.
        • Katis A.
        Reliability of EMG power-spectrum and amplitude of the semitendinosus and biceps femoris muscles during ramp isometric contractions.
        J. Electromyogr. Kinesiol. 2008; 18: 351-358
        • Levinger P.
        • Gilleard W.
        Tibia and rearfoot motion and ground reaction forces in subjects with patellofemoral pain syndrome during walking.
        Gait Posture. 2007; 25: 2-8
        • Magee D.J.
        Orthopedic Physical Assessment.
        5th ed. Saunders, Philadelphia2008
        • Nijs J.
        • Van Geel C.
        • Van Der Auwera C.
        • Van de Velde B.
        Diagnostic value of five clinical tests in patellofemoral pain syndrome.
        Man. Ther. 2006; 11: 69-77
        • Nunes G.S.
        • Stapait E.L.
        • Kirsten M.H.
        • de Noronha M.
        • Santos G.M.
        Clinical test for diagnosis of patellofemoral pain syndrome: systematic review with meta-analysis.
        Phys. Ther. Sport. 2013; 14: 54-59
        • Portney L.
        • Watkins M.
        Foundations of Clinical Research: Applications to Practice.
        3° ed. Pearson Prentice Hall, New Jersey2009
        • Powers C.M.
        • Maffucci R.
        • Hampton S.
        Rearfoot posture in subjects with patellofemoral pain.
        J. Orthop. Sports Phys. Ther. 1995; 22: 155-160
        • Powers C.M.
        • Heino J.G.
        • Rao S.
        • Perry J.
        The influence of patellofemoral pain on lower limb loading during gait.
        Clin. Biomech. 1999; 14: 722-728
        • Shih Y.-F.
        • Wen Y.-K.
        • Chen W.-Y.
        Application of wedged foot orthosis effectively reduces pain in runners with pronated foot: a randomized clinical study.
        Clin. Rehabil. 2011; 25: 913-923
        • Silva C.R.
        • Silva D.O.
        • Ferrari D.
        • Negrão Filho R.F.
        • Alves N.
        • de Azevedo F.M.
        Exploratory study of electromyographic behavior of the vastus medialis and vastus lateralis at neuromuscular fatigue onset.
        Mot. Rev. Educ. Fís. 2014; 20: 213-220
        • Souza T.R.
        • Pinto R.Z.
        • Trede R.G.
        • Kirkwood R.N.
        • Pertence A.E.
        • Fonseca S.T.
        Late rearfoot eversion and lower-limb internal rotation caused by changes in the interaction between forefoot and support surface.
        J. Am. Podiatr. Med. Assoc. 2009; 99: 503-511
        • Stebbins J.
        • Harrington M.
        • Thompson N.
        • Zavatsky A.
        • Theologis T.
        Repeatability of a model for measuring multi-segment foot kinematics in children.
        Gait Posture. 2006; 23: 401-410
        • Swets J.A.
        Measuring the accuracy of diagnostic systems.
        Science. 1988; 240: 1285-1293
        • Tiberio D.
        The effect of excessive subtalar joint pronation on patellofemoral mechanics: a theoretical model.
        J. Orthop. Sports Phys. Ther. 1987; 9: 160-165
        • Vicenzino B.
        • Collins N.
        • Cleland J.
        • McPoil T.
        A clinical prediction rule for identifying patients with patellofemoral pain who are likely to benefit from foot orthoses: a preliminary determination.
        Br. J. Sports Med. 2010; 44: 862-866
        • Watson C.
        • Propps M.
        • Galt W.
        • Redding A.
        • Dobbs D.
        Reliability of McConnell's classification of patellar orientation in symptomatic and asymptomatic subjects.
        J. Orthop. Sports Phys. Ther. 1999; 29: 386-393
        • Weir J.P.
        Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM.
        J. Strength Cond. Res. 2005; 19: 231-240
        • Winter D.A.
        Biomechanics and Motor Control of Human Movement.
        Fourth ed. Wiley, New Jersey2009