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John D. Willson and Irene S. Davis

Context:

Lower extremity (LE) weakness might be associated with altered mechanics during weight bearing in subjects with patellofemoral pain syndrome (PFPS).

Objective:

To analyze LE strength, mechanics, and the association between these variables among women with and without PFPS during a simulated athletic task.

Design:

Case control.

Setting:

Motion-analysis laboratory.

Subjects:

20 women with PFPS and 20 healthy women.

Main Outcome Measures:

Peak isometric lateral trunk-flexion, hip-abduction, hip external-rotation, knee-flexion, and knee-extension strength, as well as hip- and knee-joint excursions and angular impulses during single-leg jumps.

Results:

PFPS subjects produced less hip-abduction, hip external-rotation, and trunk lateral-flexion force than the control group. The PFPS group also demonstrated greater hip-adduction excursion and hip-abduction impulses. The association between the strength measurements and LE mechanics was low.

Conclusions:

Women with PFPS demonstrate specific weaknesses and altered LE mechanics. Weakness is not, however, highly correlated with observed differences in mechanics.

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Rebecca E. Fellin, Kurt Manal and Irene S. Davis

Researchers conduct gait analyses utilizing both overground and treadmill modes of running. Previous studies comparing these modes analyzed discrete variables. Recently, techniques involving quantitative pattern analysis have assessed kinematic curve similarity in gait. Therefore, the purpose of this study was to compare hip, knee and rearfoot 3-D kinematics between overground and treadmill running using quantitative kinematic curve analysis. Twenty runners ran at 3.35 m/s ± 5% during treadmill and overground conditions while right lower extremity kinematics were recorded. Kinematics of the hip, knee and rearfoot at footstrike and peak were compared using intraclass correlation coefficients. Kinematic curves during stance phase were compared using the trend symmetry method within each subject. The overall average trend symmetry was high, 0.94 (1.0 is perfect symmetry) between running modes. The transverse plane and knee frontal plane exhibited lower similarity (0.86–0.90). Other than a 4.5 degree reduction in rearfoot dorsiflexion at footstrike during treadmill running, all differences were ≤1.5 degrees. 17/18 discrete variables exhibited modest correlations (>0.6) and 8/18 exhibited strong correlations (>0.8). In conclusion, overground and treadmill running kinematic curves were generally similar when averaged across subjects. Although some subjects exhibited differences in transverse plane curves, overall, treadmill running was representative of overground running for most subjects.

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Joaquin A. Barrios, Todd D. Royer and Irene S. Davis

Dynamic knee alignment is speculated to have a stronger relationship to medial knee loading than radiographic alignment. Therefore, we aimed to determine what frontal plane knee kinematic variable correlated most strongly to the knee adduction moment. That variable was then compared with radiographic alignment as a predictor of the knee adduction moment. Therefore, 55 subjects with medial knee OA underwent three-dimensional gait analysis. A subset of 21 subjects also underwent full-limb radiographic assessment for knee alignment. Correlations and regression analyses were performed to assess the relationships between the kinematic, kinetic and radiographic findings. Peak knee adduction angle most strongly correlated to the knee adduction moment of the kinematic variables. In comparison with radiographic alignment, peak knee adduction angle was the stronger predictor. Given that most epidemiological studies on knee OA use radiographic alignment in an attempt to understand progression, these results are meaningful.

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Christopher L. MacLean, Irene S. Davis and Joseph Hamill

The purpose of this study was to analyze the influence of varying running shoe midsole composition on lower extremity dynamics with and without a custom foot orthotic intervention. Three-dimensional dynamics were collected on 12 female runners who had completed 6 weeks of custom foot orthotic therapy. Participants completed running trials in 3 running shoe midsole conditions—with and without a custom foot orthotic intervention. Results from the current study revealed that only maximum rearfoot eversion velocity was influenced by the midsole durometer of the shoe. Maximum rearfoot eversion velocity was significantly decreased for the hard shoe compared with the soft shoe. However, the orthotic intervention in the footwear led to significant decreases in several dynamic variables. The results suggest that the major component influencing the rearfoot dynamics was the orthotic device and not the shoe composition. In addition, data suggest that the foot orthoses appear to compensate for the lesser shoe stability enabling it to function in a way similar to that of a shoe of greater stability.

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David R. Mullineaux, Clare E. Milner, Irene S. Davis and Joseph Hamill

The appropriateness of normalizing data, as one method to reduce the effects of a covariate on a dependent variable, should be evaluated. Using ratio, 0.67-nonlinear, and fitted normalizations, the aim of this study was to investigate the relationship between ground reaction force variables and body mass (BM). Ground reaction forces were recorded for 40 female subjects running at 3.7 ± 0.18 m·s–1 (mass = 58 ± 6 kg). The explained variance for mass to forces (peak-impact-vertical = 70%; propulsive-vertical = 27%; braking = 40%) was reduced to < 0.1% for mass to ratio normalized forces (i.e., forces/BM1) with statistically significantly different power exponents (p < 0.05). The smaller covariate effect of mass on loading rate variables of 2–16% was better removed through fitted normalization (e.g., vertical-instantaneous-loading-rate/BM0.69±0.93; ±95% CI) with nonlinear power exponents ranging from 0.51 to 1.13. Generally, these were similar to 0.67 as predicted through dimensionality theory, but, owing to the large confidence intervals, these power exponents were not statistically significantly different from absolute or ratio normalized data (p > 0.05). Further work is warranted to identify the appropriate method to normalize loading rates either to mass or to another covariate. Ratio normalization of forces to mass, as predicted through Newtonian mechanics, is recommended for comparing subjects of different masses.