Relationship Between Hip Frontal Dynamic Joint Stiffness and Frontal and Transverse Plane Hip Kinematics During Gait: Sex Differences

in Journal of Sport Rehabilitation

Click name to view affiliation

Shogo Takano
Search for other papers by Shogo Takano in
Current site
Google Scholar
PubMed
Close
,
Yoshitaka Iwamoto
Search for other papers by Yoshitaka Iwamoto in
Current site
Google Scholar
PubMed
Close
,
Junya Ozawa
Search for other papers by Junya Ozawa in
Current site
Google Scholar
PubMed
Close
, and
Nobuhiro Kito
Search for other papers by Nobuhiro Kito in
Current site
Google Scholar
PubMed
Close
Restricted access

Context: Previous studies have reported that the incidence of patellofemoral pain in women is 2.2 times higher than that in men. Lower hip frontal dynamic joint stiffness in women may be related to the magnitude of hip adduction and internal rotation associated with patellofemoral pain. Objective: To identify sex differences in hip frontal dynamic joint stiffness and examine the relationship between hip frontal dynamic joint stiffness and hip adduction and internal rotation during gait. Design: Cross-sectional study. Setting: University campus. Participants: A total of 80 healthy volunteers (40 women and 40 men) participated in this study. Intervention(s): Kinematic and kinetic data during gait were collected using a motion capture system and force plates. Main Outcome Measures: Hip frontal dynamic joint stiffness, hip adduction, and hip internal rotation were calculated during gait. Results: Women demonstrated lower hip frontal dynamic joint stiffness than men during gait (P < .01). They also displayed decreased hip frontal dynamic joint stiffness associated with increased hip adduction (r = −.85, P < .001) and internal rotation (r = −.48, P < .001). Conversely, in men, decreased hip frontal dynamic joint stiffness was associated with increased hip adduction (r = −.74, P < .001) but not internal rotation (r = .17, P = .28). Conclusions: Sex differences between hip frontal dynamic joint stiffness and hip internal rotation during gait may contribute to the increased incidence of patellofemoral pain in women.

Takano is with the Major in Medical Engineering and Technology, Graduate School of Medical Technology and Health Welfare Science, Hiroshima International University, Hiroshima, Japan. Iwamoto is with the Faculty of Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. Ozawa and Kito are with the Faculty of General Rehabilitation, Hiroshima International University, Hiroshima, Japan.

Kito (n-kito@hirokoku-u.ac.jp) is corresponding author.
  • Collapse
  • Expand
  • 1.

    Glaviano NR, Kew M, Hart JM, Saliba S. Demographic and epidemiological trends in patellofemoral pain. Int J Sports Phys Ther. 2015;10(3):281290. PubMed ID: 26075143

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med. 2002;36(2):95101. PubMed ID: 11916889 doi:10.1136/bjsm.36.2.95

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Boling M, Padua D, Marshall S, Guskiewicz K, Pyne S, Beutler A. Gender differences in the incidence and prevalence of patellofemoral pain syndrome. Scand J Med Sci Sports. 2010;20(5):725730. PubMed ID: 19765240 doi:10.1111/j.1600-0838.2009.00996.x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Graci V, Van Dillen LR, Salsich GB. Gender differences in trunk, pelvis and lower limb kinematics during a single leg squat. Gait Posture. 2012;36(3):461466. PubMed ID: 22591790 doi:10.1016/j.gaitpost.2012.04.006

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Hurd WJ, Chmielewski TL, Axe MJ, Davis I, Snyder-Mackler L. Differences in normal and perturbed walking kinematics between male and female athletes. Clin Biomech. 2004;19(5):465472. doi:10.1016/j.clinbiomech.2004.01.013

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Bruening DA, Frimenko RE, Goodyear CD, Bowden DR, Fullenkamp AM. Sex differences in whole body gait kinematics at preferred speeds. Gait Posture. 2015;41(2):540545. PubMed ID: 25548119 doi:10.1016/j.gaitpost.2014.12.011

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Chumanov ES, Wall-Scheffler C, Heiderscheit BC. Gender differences in walking and running on level and inclined surfaces. Clin Biomech. 2008;23(10):12601268. doi:10.1016/j.clinbiomech.2008.07.011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Almonroeder TG, Benson LC. Sex differences in lower extremity kinematics and patellofemoral kinetics during running. J Sports Sci. 2017;35(16):15751581. PubMed ID: 27571504

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Weeks BK, Carty CP, Horan SA. Effect of sex and fatigue on single leg squat kinematics in healthy young adults. BMC Musculoskelet Disord. 2015;16(1):271. PubMed ID: 26423154 doi:10.1186/s12891-015-0739-3

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Mirzaie G, Kajbafvala M, Rahimi A, Manshadi FD, Kalantari KK. Altered hip mechanics and patellofemoral pain. A review of literature. Ortop Traumatol Rehabil. 2016;18(3):215221. PubMed ID: 28157077 doi:10.5604/15093492.1212855

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Liao TC, Yin L, Powers CM. The influence of isolated femur and tibia rotations on patella cartilage stress: a sensitivity analysis. Clin Biomech. 2018;54:125131. doi:10.1016/j.clinbiomech.2018.03.003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Heino Brechter J, Powers CM. Patellofemoral stress during walking in persons with and without patellofemoral pain. Med Sci Sports Exerc. 2002;34(10):15821593. doi:10.1097/00005768-200210000-00009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Ward SR, Powers CM. The influence of patella alta on patellofemoral joint stress during normal and fast walking. Clin Biomech. 2004;19(10):10401047. doi:10.1016/j.clinbiomech.2004.07.009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Powers CM. The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther. 2010;40(2):4251. PubMed ID: 20118526 doi:10.2519/jospt.2010.3337

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Willson JD, Davis IS. Lower extremity strength and mechanics during jumping in women with patellofemoral pain. J Sport Rehabil. 2009;18(1):7690. PubMed ID: 19321908 doi:10.1123/jsr.18.1.76

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Baggaley M, Noehren B, Clasey JL, Shapiro R, Pohl MB. Frontal plane kinematics of the hip during running: are they related to hip anatomy and strength? Gait Posture. 2015;42(4):505510. PubMed ID: 26364243 doi:10.1016/j.gaitpost.2015.07.064

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Herman DC, Weinhold PS, Guskiewicz KM, Garrett WE, Yu B, Padua DA. The effects of strength training on the lower extremity biomechanics of female recreational athletes during a stop-jump task. Am J Sports Med. 2008;36(4):733740. PubMed ID: 18212346 doi:10.1177/0363546507311602

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Neal BS, Barton CJ, Gallie R, O’Halloran P, Morrissey D. Runners with patellofemoral pain have altered biomechanics which targeted interventions can modify: a systematic review and meta-analysis. Gait Posture. 2016;45:6982. PubMed ID: 26979886 doi:10.1016/j.gaitpost.2015.11.018

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Davis RB, DeLuca PA. Gait characterization via dynamic joint stiffness. Gait Posture. 1996;4(3):224231. doi:10.1016/0966-6362(95)01045-9

  • 20.

    Butler RJ, Crowell HP 3rd, Davis IM. Lower extremity stiffness: implications for performance and injury. Clin Biomech. 2003;18(6):511517. doi:10.1016/S0268-0033(03)00071-8

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Zeni JA Jr, Higginson JS. Dynamic knee joint stiffness in subjects with a progressive increase in severity of knee osteoarthritis. Clin Biomech. 2009;24(4):366371. doi:10.1016/j.clinbiomech.2009.01.005

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Latash ML, Zatsiorsky VM. Joint stiffness: myth or reality? Hum Mov Sci. 1993;12(6):653692. doi:10.1016/0167-9457(93)90010-M

  • 23.

    Granata KP, Padua DA, Wilson SE. Gender differences in active musculoskeletal stiffness. Part II. Quantification of leg stiffness during functional hopping tasks. J Electromyogr Kinesiol. 2002;12(2):127135. PubMed ID: 11955985 doi:10.1016/S1050-6411(02)00003-2

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Al-Hayani A. The functional anatomy of hip abductors. Folia Morphol. 2009;68(2):98103.

  • 25.

    Hu H, Meijer OG, Hodges PW, et al. Control of the lateral abdominal muscles during walking. Hum Mov Sci. 2012;31(4):880896. PubMed ID: 22119422 doi:10.1016/j.humov.2011.09.002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Wojtys EM, Ashton-Miller JA, Huston LJ. A gender-related difference in the contribution of the knee musculature to sagittal-plane shear stiffness in subjects with similar knee laxity. J Bone Joint Surg Am. 2002;84(1):1016. PubMed ID: 11792773 doi:10.2106/00004623-200201000-00002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Wojtys EM, Huston LJ, Schock HJ, Boylan JP, Ashton-Miller JA. Gender differences in muscular protection of the knee in torsion in size-matched athletes. J Bone Joint Surg Am. 2003;85(5):782789. PubMed ID: 12728025 doi:10.2106/00004623-200305000-00002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Granata KP, Wilson SE, Padua DA. Gender differences in active musculoskeletal stiffness. Part I. Quantification in controlled measurements of knee joint dynamics. J Electromyogr Kinesiol. 2002;12(2):119126. PubMed ID: 11955984 doi:10.1016/S1050-6411(02)00002-0

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Staron RS, Hagerman FC, Hikida RS, et al. Fiber type composition of the vastus lateralis muscle of young men and women. J Histochem Cytochem. 2000;48(5):623629. PubMed ID: 10769046 doi:10.1177/002215540004800506

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Snyder KR, Earl JE, O’Connor KM, Ebersole KT. Resistance training is accompanied by increases in hip strength and changes in lower extremity biomechanics during running. Clin Biomech. 2009;24(1):2634. doi:10.1016/j.clinbiomech.2008.09.009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    Sawada T, Tokuda K, Tanimoto K, et al. Foot alignments influence the effect of knee adduction moment with lateral wedge insoles during gait. Gait Posture. 2016;49:451456. PubMed ID: 27541338 doi:10.1016/j.gaitpost.2016.08.011

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Bell A, Brand RA, Pedersen DR. Prediction of hip joint centre location from external landmarks. Hum Mov Sci. 1989;8(1):316. doi:10.1016/0167-9457(89)90020-1

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33.

    Wirtz AD, Willson JD, Kernozek TW, Hong DA. Patellofemoral joint stress during running in females with and without patellofemoral pain. Knee. 2012;19(5):703708. PubMed ID: 22000909 doi:10.1016/j.knee.2011.09.006

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Ardestani MM, Ferrigno C, Moazen M, Wimmer MA. From normal to fast walking: impact of cadence and stride length on lower extremity joint moments. Gait Posture. 2016;46:118125. PubMed ID: 27131188 doi:10.1016/j.gaitpost.2016.02.005

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Ferber R, Davis IM, Williams DS 3rd. Gender differences in lower extremity mechanics during running. Clin Biomech. 2003;18(4):350357. doi:10.1016/S0268-0033(03)00025-1

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36.

    Chaudhari AM, Andriacchi TP. The mechanical consequences of dynamic frontal plane limb alignment for non-contact ACL injury. J Biomech. 2006;39(2):330338. PubMed ID: 16321635 doi:10.1016/j.jbiomech.2004.11.013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Lewis CL, Laudicina NM, Khuu A, Loverro KL. The human pelvis: variation in structure and function during gait. Anat Rec. 2017;300(4):633642.

  • 38.

    Braten M, Terjesen T, Rossvoll I. Femoral anteversion in normal adults. Ultrasound measurements in 50 men and 50 women. Acta Orthop Scand. 1992;63(1):2932. PubMed ID: 1738965

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Radler C, Kranzl A, Manner HM, Hoglinger M, Ganger R, Grill F. Torsional profile versus gait analysis: consistency between the anatomic torsion and the resulting gait pattern in patients with rotational malalignment of the lower extremity. Gait Posture. 2010;32(3):405410. PubMed ID: 20655226 doi:10.1016/j.gaitpost.2010.06.019

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Ryan ED, Herda TJ, Costa PB, et al. Passive properties of the muscle-tendon unit: the influence of muscle cross-sectional area. Muscle Nerve. 2009;39(2):227229. PubMed ID: 19145654 doi:10.1002/mus.21218

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Souza RB, Powers CM. Predictors of hip internal rotation during running: an evaluation of hip strength and femoral structure in women with and without patellofemoral pain. Am J Sports Med. 2009;37(3):579587. PubMed ID: 19098153 doi:10.1177/0363546508326711

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Hollman JH, Galardi CM, Lin IH, Voth BC, Whitmarsh CL. Frontal and transverse plane hip kinematics and gluteus maximus recruitment correlate with frontal plane knee kinematics during single-leg squat tests in women. Clin Biomech. 2014;29(4):468474. doi:10.1016/j.clinbiomech.2013.12.017

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 43.

    Gustafson JA, Gorman S, Fitzgerald GK, Farrokhi S. Alterations in walking knee joint stiffness in individuals with knee osteoarthritis and self-reported knee instability. Gait Posture. 2016;43:210215. PubMed ID: 26481256 doi:10.1016/j.gaitpost.2015.09.025

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Liao TC, Yang N, Ho KY, Farrokhi S, Powers CM. Femur rotation increases patella cartilage stress in females with patellofemoral pain. Med Sci Sports Exerc. 2015;47(9):17751780. PubMed ID: 25606814 doi:10.1249/MSS.0000000000000617

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 2339 796 21
Full Text Views 32 5 0
PDF Downloads 35 8 0