Relationship between vastus medialis Hoffmann reflex excitability and knee extension biomechanics during different tasks in women with patellofemoral pain

  • Marina Cabral Waiteman
    Correspondence
    Corresponding author at: Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), 305, Roberto Simonsen Street, Presidente Prudente, Sao Paulo 19060-900, Brazil.
    Affiliations
    Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil
    Search for articles by this author
  • Ana Flavia Balotari Botta
    Affiliations
    Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil
    Search for articles by this author
  • Vitória Ozores Perez
    Affiliations
    Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil
    Search for articles by this author
  • Danilo de Oliveira Silva
    Affiliations
    La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
    Search for articles by this author
  • Marcella Ferraz Pazzinatto
    Affiliations
    La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
    Search for articles by this author
  • Fernando Henrique Magalhães
    Affiliations
    Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil

    School of Arts, Sciences, and Humanities, University of Sao Paulo, Sao Paulo, Brazil
    Search for articles by this author
  • Fábio Mícolis de Azevedo
    Affiliations
    Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil
    Search for articles by this author
  • Ronaldo Valdir Briani
    Affiliations
    Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil
    Search for articles by this author

      Highlights

      • Spinal excitability is related with quadriceps steadiness in patellofemoral pain.
      • Spinal excitability is related with isometric strength in patellofemoral pain.
      • Spinal excitability is not related with dynamic strength in patellofemoral pain.
      • Spinal excitability is not related with knee extensor moment in patellofemoral pain.

      Abstract

      Background

      Impaired knee extension biomechanics and spinal excitability have been reported in women with patellofemoral pain, but their relationship has not been explored. A significant relationship between them could indicate the need for investigating the potential benefits of disinhibitory interventions for women with patellofemoral pain. Thus, this study aimed to investigate the relationship between vastus medialis Hoffmann reflex and (1) maximal isometric, concentric and eccentric knee extensor strength and rate of torque development; (2) knee extensor torque steadiness; and (3) knee extensor moment during functional tasks; in women with patellofemoral pain.

      Methods

      Spinal excitability of twenty-four participants was assessed by the amplitude of maximal vastus medialis Hoffmann reflex. Knee extensor strength, rate of torque development and torque steadiness were assessed using an isokinetic dynamometer. Knee extensor moment during step-down and stair descent tasks were obtained using a three-dimensional motion analysis system.

      Findings

      A moderate negative relationship was found between vastus medialis Hoffmann reflex and knee extensor torque steadiness (r = −0.35; p = 0.05); whereas a moderate positive relationship was found with maximal isometric knee extensor strength (r = 0.37; p = 0.044). No significant relationships were found between vastus medialis Hoffmann reflex and the other variables.

      Interpretation

      Our findings provide insight on the relationship between spinal excitability and neuromuscular control of maximal and submaximal isometric torque production in women with patellofemoral pain. Conversely, spinal excitability does not seem to be related with dynamic torques and moments of the knee extensors in women with patellofemoral pain.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic and Personal
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Biomechanics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Alsaleh S.A.
        • Murphy N.
        • Miller S.C.
        • Morrissey D.
        • Lack S.D.
        Local neuromuscular characteristics associated with patellofemoral pain: a systematic review and meta-analysis.
        Clin. Biomech. 2021; https://doi.org/10.1016/j.clinbiomech.2021.105509
        • Baker V.
        • Bennell K.
        • Stillman B.
        • Cowan S.
        • Crossley K.
        Abnormal knee joint position sense in individuals with patellofemoral pain syndrome.
        J. Orthop. Res. 2002; 20: 208-214https://doi.org/10.1016/S0736-0266(01)00106-1
        • Barton C.J.
        • De Oliveira Silva D.
        • Morton S.
        • Collins N.J.
        • Rathleff M.S.
        • Vicenzino B.
        • Van Middelkoop M.
        • Crossley K.M.
        • Callaghan M.J.
        • Selfe J.
        • Holden S.
        • Lack S.
        • Macri E.M.
        • Bazett-Jones D.M.
        • Earl-Boehm J.E.
        • Riel H.
        • Powers C.M.
        • Davis I.S.
        • Morrissey D.
        REPORT-PFP: a consensus from the international patellofemoral research network to improve REPORTing of quantitative PatelloFemoral pain studies.
        Br. J. Sports Med. 2021; 55: 1135-1143https://doi.org/10.1136/bjsports-2020-103700
        • Briani R.V.
        • De Oliveira Silva D.
        • Flóride C.S.
        • Aragão F.A.
        • De Albuquerque C.E.
        • Magalhães F.H.
        • De Azevedo F.M.
        Quadriceps neuromuscular function in women with patellofemoral pain: influences of the type of the task and the level of pain.
        PLoS One. 2018; 13e0205553https://doi.org/10.1371/journal.pone.0205553
        • Briani R.V.
        • Cannon J.
        • Waiteman M.C.
        • Negrão Filho R.
        • De F.
        • Magalhães F.H.
        • de Azevedo F.M.
        Influence of the exacerbation of patellofemoral pain on trunk kinematics and lower limb mechanics during stair negotiation.
        Gait Posture. 2021; 83: 83-87https://doi.org/10.1016/j.gaitpost.2020.10.008
        • Briani R.V.
        • de Oliveira Silva D.
        • Ducatti M.H.M.
        • Lopes H.S.
        • Ferreira A.S.
        • Mentiplay B.
        • de Azevedo F.M.
        • Barton C.J.
        Knee flexor strength and rate of torque development deficits in women with patellofemoral pain are related to poor objective function.
        Gait Posture. 2021; 83: 100-106https://doi.org/10.1016/j.gaitpost.2020.10.011
        • Coburn J.W.
        • Housh T.J.
        • Cramer J.T.
        • Weir J.P.
        • Miller J.M.
        • Beck T.W.
        • Malek M.H.
        • Johnson G.O.
        Mechanomyographic and electromyographic responses of the vastus medialis muscle during isometric and concentric muscle actions.
        J. Strength Cond. Res. 2005; 19: 412-420https://doi.org/10.1519/15744.1
        • Coburn S.L.
        • Barton C.J.
        • Filbay S.R.
        • Hart H.F.
        • Rathleff M.S.
        • Crossley K.M.
        Quality of life in individuals with patellofemoral pain: a systematic review including meta-analysis.
        Phys. Ther. Sport. 2018; 33: 96-108https://doi.org/10.1016/j.ptsp.2018.06.006
        • Cohen J.
        Statistical Power Analysis for the Behavioral Sciences.
        Routledge, New York1988
        • Crossley K.M.
        • Stefanik J.J.
        • Selfe J.
        • Collins N.J.
        • Davis I.S.
        • Powers C.M.
        • Mcconnell J.
        • Vicenzino B.
        • Bazett-jones D.M.
        • Esculier J.
        • Morrissey D.
        • Callaghan M.J.
        2016 patellofemoral pain consensus statement from the 4th international patellofemoral pain research retreat, Manchester. Part 1: terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome m.
        Br. J. Sports Med. 2016; 50: 839-843https://doi.org/10.1136/bjsports-2016-096384
        • Davi S.M.
        • Lepley A.S.
        • Denegar C.R.
        • DiStefano L.J.
        • Edgar C.M.
        • Lepley L.K.
        Quadriceps inhibition after naturally occurring patellar tendon damage and pain.
        J. Athl. Train. 2020; 55: 608-614https://doi.org/10.4085/1062-6050-27-19
        • De Oliveira Silva D.
        • Magalhães F.H.
        • Faria N.C.
        • Pazzinatto M.F.
        • Ferrari D.
        • Pappas E.
        • De Azevedo F.M.
        Lower amplitude of the hoffmann reflex in women with patellofemoral pain: thinking beyond proximal, local, and distal factors.
        Arch. Phys. Med. Rehabil. 2016; 97: 1115-1120https://doi.org/10.1016/j.apmr.2015.12.017
        • De Oliveira Silva D.
        • Magalhães F.H.
        • Faria N.C.
        • Ferrari D.
        • Pazzinatto M.F.
        • Pappas E.
        • de Azevedo F.M.
        Vastus medialis hoffmann reflex excitability is associated with pain level, self-reported function, and chronicity in women with patellofemoral pain.
        Arch. Phys. Med. Rehabil. 2017; 98: 114-119https://doi.org/10.1016/j.apmr.2016.06.011
        • Doguet V.
        • Jubeau M.
        Reliability of H-reflex in vastus lateralis and vastus medialis muscles during passive and active isometric conditions.
        Eur. J. Appl. Physiol. 2014; 114: 2509-2519https://doi.org/10.1007/s00421-014-2969-8
        • Ferreira A.S.
        • de Oliveira Silva D.
        • Ferrari D.
        • Magalhães F.H.
        • Pappas E.
        • Briani R.V.
        • Pazzinatto M.F.
        • de Azevedo F.M.
        Knee and hip isometric force steadiness are impaired in women with patellofemoral pain.
        J. Strength Cond. Res. 2021; 35: 2878-2885https://doi.org/10.1519/jsc.0000000000003215
        • Gallina A.
        • Hunt M.A.
        • Hodges P.
        • Garland S.J.
        Vastus lateralis motor unit firing rate is higher in females with patellofemoral pain.
        Arch. Phys. Med. Rehabil. 2018; 99: 907-913https://doi.org/10.1016/j.apmr.2018.01.019
        • Glaviano N.
        • Saliba S.
        Relationship between lower extremity strength and subjective function in individuals with patellofemoral pain.
        J. Sport Rehabil. 2018; 27: 327-333https://doi.org/10.1123/jsr.2016-0177
        • Glaviano N.R.
        • Baellow A.
        • Saliba S.
        Physical activity levels in individuals with and without patellofemoral pain.
        Phys. Ther. Sport. 2017; 27: 12-16https://doi.org/10.1016/j.ptsp.2017.07.002
        • Greuel H.
        • Herrington L.
        • Liu A.
        • Jones R.K.
        How does acute pain influence biomechanics and quadriceps function in individuals with patellofemoral pain?.
        Knee. 2019; 26: 330-338https://doi.org/10.1016/j.knee.2018.12.008
        • Hart J.M.
        • Pietrosimone B.
        • Hertel J.
        • Ingersoll C.D.
        Quadriceps activation following knee injuries: a systematic review.
        J. Athl. Train. 2010; 45: 87-97https://doi.org/10.4085/1062-6050-45.1.87
        • Hassanzahraee M.
        • Zoghi M.
        • Jaberzadeh S.
        How different priming stimulations affect the corticospinal excitability induced by noninvasive brain stimulation techniques: a systematic review and meta-analysis.
        Rev. Neurosci. 2018; 29: 883-899https://doi.org/10.1515/revneuro-2017-0111
        • Hopkins J.T.
        • Ingersoll C.D.
        Arthrogenic muscle inhibition: a limiting factor in joint rehabilitation.
        J. Sport Rehabil. 2000; 9: 135-159https://doi.org/10.1123/jsr.9.2.135
        • Hortobágyi T.
        • Garry J.
        • Holbert D.
        • Devita P.
        Aberrations in the control of quadriceps muscle force in patients with knee osteoarthritis.
        Arthritis Care Res. 2004; 51: 562-569https://doi.org/10.1002/art.20545
        • Klass M.
        • Roelands B.
        • Meeusen R.
        • Duchateau J.
        Acute effect of noradrenergic modulation on motor output adjustment in men.
        Med. Sci. Sports Exerc. 2018; 50: 1579-1587https://doi.org/10.1249/MSS.0000000000001622
        • Kuchinad R.A.
        • Ivanova T.D.
        • Garland S.J.
        Modulation of motor unit discharge rate and H-reflex amplitude during submaximal fatigue of the human soleus muscle.
        Exp. Brain Res. 2004; 158: 345-355https://doi.org/10.1007/s00221-004-1907-0
        • Lepley A.S.
        • Ericksen H.M.
        • Sohn D.H.
        • Pietrosimone B.G.
        Contributions of neural excitability and voluntary activation to quadriceps muscle strength following anterior cruciate ligament reconstruction.
        Knee. 2014; 21: 736-742https://doi.org/10.1016/j.knee.2014.02.008
        • Liao T.-C.
        • Keyak J.H.
        • Powers C.M.
        Runners with patellofemoral pain exhibit greater peak patella cartilage stress compared to pain-free runners.
        J. Appl. Biomech. 2018; 34: 298-305https://doi.org/10.1123/jab.2017-0229
        • Maclachlan L.R.
        • Matthews M.
        • Hodges P.W.
        • Collins N.J.
        • Vicenzino B.
        The psychological features of patellofemoral pain: a cross-sectional study.
        Scand J Pain. 2018; 18: 261-271https://doi.org/10.1515/sjpain-2018-0025
        • Maffiuletti N.A.
        • Aagaard P.
        • Blazevich A.J.
        • Folland J.
        • Tillin N.
        • Duchateau J.
        Rate of force development: physiological and methodological considerations.
        Eur. J. Appl. Physiol. 2016; 116: 1091-1116https://doi.org/10.1007/s00421-016-3346-6
        • Palmieri R.M.
        • Ingersoll C.D.
        • Hoffman M.A.
        The Hoffmann reflex: methodologic considerations and applications for use in sports medicine and athletic training research.
        J. Athl. Train. 2004; 39: 268-277https://doi.org/10.1007/s00421-003-0967-3
        • Park J.
        • Hopkins J.T.
        Induced anterior knee pain immediately reduces involuntary and voluntary quadriceps activation.
        Clin. J. Sport Med. 2013; 23: 19-24https://doi.org/10.1097/JSM.0b013e3182717b7b
        • Park K.-M.
        • Cynn H.-S.
        • Choung S.-D.
        Musculoskeletal predictors of movement quality for the forward step-down test in asymptomatic women.
        J. Orthop. Sport. Phys. Ther. 2013; 43: 504-510https://doi.org/10.2519/jospt.2013.4073
        • Pietrosimone B.G.
        • Hopkins J.T.
        • Ingersoll C.D.
        The role of disinhibitory modalities in joint injury rehabilitation.
        Athl. Ther. Today. 2008; 13: 2-5https://doi.org/10.1123/att.13.6.2
        • Pua Y.H.
        • Ong P.H.
        • Ho J.Y.
        • Bryant A.L.
        • Webster E.
        • Clark R.A.
        Associations of isokinetic knee steadiness with hop performance in patients with ACL deficiency. Knee surgery.
        Sport. Traumatol. Arthrosc. 2015; 23: 2185-2195https://doi.org/10.1007/s00167-014-2995-4
        • Rice D.A.
        • McNair P.J.
        Quadriceps arthrogenic muscle inhibition: neural mechanisms and treatment perspectives.
        Semin. Arthritis Rheum. 2010; 40: 250-266https://doi.org/10.1016/j.semarthrit.2009.10.001
        • Rice D.A.
        • McNair P.J.
        • Lewis G.N.
        • Mannion J.
        Experimental knee pain impairs submaximal force steadiness in isometric, eccentric, and concentric muscle actions.
        Arthritis Res. Ther. 2015; 17: 259https://doi.org/10.1186/s13075-015-0768-1
        • Salsich G.B.
        • Brechter J.H.
        • Powers C.M.
        Lower extremity kinetics during stair ambulation in patients with and without patellofemoral pain.
        Clin. Biomech. 2001; 16: 906-912https://doi.org/10.101016/S0268-0033(01)00085-7
        • Smith B.E.
        • Selfe J.
        • Thacker D.
        • Hendrick P.
        • Bateman M.
        • Moffatt F.
        • Rathleff M.S.
        • Smith T.O.
        • Logan P.
        Incidence and prevalence of patellofemoral pain: a systematic review and meta-analysis.
        PLoS One. 2018; 13e0190892https://doi.org/10.1371/journal.pone.0190892
        • Sonnery-Cottet B.
        • Saithna A.
        • Quelard B.
        • Daggett M.
        • Borade A.
        • Ouanezar H.
        • Thaunat M.
        • Blakeney W.G.
        Arthrogenic muscle inhibition after ACL reconstruction: a scoping review of the efficacy of interventions.
        Br. J. Sports Med. 2019; 53: 289-298https://doi.org/10.1136/bjsports-2017-098401
        • Souza R.B.
        • Powers C.M.
        Differences in hip kinematics, muscle strength, and muscle activation between subjects with and without patellofemoral pain.
        J. Orthop. Sports Phys. Ther. 2009; 39: 12-19https://doi.org/10.2519/jospt.2009.2885
        • Stathopulu E.
        • Baildam E.
        Anterior knee pain: a long-term follow-up.
        Rheumatology. 2003; 42: 380-382https://doi.org/10.1093/rheumatology/keg093
        • Talbot L.A.
        • Solomon Z.
        • Webb L.
        • Morrell C.
        • Metter E.J.
        Electrical stimulation therapies for active duty military with patellofemoral pain syndrome: a randomized trial.
        Mil. Med. 2020; 185: e963-e971https://doi.org/10.1093/milmed/usaa037
        • Te M.
        • Baptista A.F.
        • Chipchase L.S.
        • Schabrun S.M.
        Primary motor cortex organization is altered in persistent patellofemoral pain.
        Pain Med. 2017; 18: 2224-2234https://doi.org/10.1093/pm/pnx036
        • von Elm E.
        • Altman D.G.
        • Egger M.
        • Pocock S.J.
        • Gøtzsche P.C.
        • Vandenbroucke J.P.
        The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies.
        J. Clin. Epidemiol. 2008; 61: 344-349https://doi.org/10.1016/j.jclinepi.2007.11.008
        • Waiteman M.C.
        • Briani R.V.
        • Ferraz Pazzinatto M.
        • Ferreira A.S.
        • Ferrari D.
        • De Oliveira Silva D.
        • Mícolis De Azevedo F.
        Relationship between knee abduction moment with patellofemoral joint reaction force, stress and self-reported pain during stair descent in women with patellofemoral pain.
        Clin. Biomech. 2018; 59: 110-116https://doi.org/10.1016/j.clinbiomech.2018.09.012
        • Watanabe R.N.
        • Magalhães F.H.
        • Elias L.A.
        • Chaud V.M.
        • Mello E.M.
        • Kohn A.F.
        Influences of premotoneuronal command statistics on the scaling of motor output variability during isometric plantar flexion.
        J. Neurophysiol. 2013; 110: 2592-2606https://doi.org/10.1152/jn.00073.2013
        • Willy R.W.
        • Hoglund L.T.
        • Barton C.J.
        • Bolgla L.A.
        • Scalzitti D.A.
        • Logerstedt D.S.
        • Lynch A.D.
        • Snyder-Mackler L.
        • Mcdonough C.M.
        Patellofemoral pain: clinical practice guidelines linked to the international classification of functioning, disability and health from the academy of Orthopaedic physical therapy of the American Physical Therapy Association.
        J. Orthop. Sports Phys. Ther. 2019; 49 (CPG1–CPG95)https://doi.org/10.2519/jospt.2019.0302
        • Winter D.
        Biomechanics and Motor Control of Human Movement.
        4th ed. Hoboken, New Jersey2009