Plantar pressures and patellofemoral pain syndrome

NewsBot · May 10, 2011

Members do not see these Ads. Sign Up.
Influence of patellofemoral pain syndrome on plantar pressure in the foot rollover process during gait.
Aliberti S, Costa Mde S, Passaro Ade C, Arnone AC, Hirata R, Sacco IC.
Clinics (Sao Paulo). 2011;66(3):367-72.

BACKGROUND:
Patellofemoral Pain Syndrome is one of the most common knee disorders among physically active young women. Despite its high incidence, the multifactorial etiology of this disorder is not fully understood.

OBJECTIVES:
To investigate the influence of Patellofemoral Pain Syndrome on plantar pressure distribution during the foot rollover process (i.e., the initial heel contact, midstance and propulsion phases) of the gait.

MATERIALS AND METHODS:
Fifty-seven young adults, including 22 subjects with Patellofemoral Pain Syndrome (30 ± 7 years, 165 ± 9 cm, 63 ± 12 kg) and 35 control subjects (29 ± 7 years, 164 ± 8 cm, 60 ± 11 kg), volunteered for the study. The contact area and peak pressure were evaluated using the Pedar-X system (Novel, Germany) synchronized with ankle sagittal kinematics.

RESULTS:
Subjects with Patellofemoral Pain Syndrome showed a larger contact area over the medial (p = 0.004) and central (p = 0.002) rearfoot at the initial contact phase and a lower peak pressure over the medial forefoot (p = 0.033) during propulsion when compared with control subjects.

CONCLUSIONS:
Patellofemoral Pain Syndrome is related to a foot rollover pattern that is medially directed at the rearfoot during initial heel contact and laterally directed at the forefoot during propulsion. These detected alterations in the foot rollover process during gait may be used to develop clinical interventions using insoles, taping and therapeutic exercise to rehabilitate this dysfunction.
Click to expand...

Admin2 · May 10, 2011

Related threads:
Other threads tagged with patellofemoral pain
Foot pronation and knee pain
Patellofemoral pain and asymmetrical hip rotation
Role of foot orthoses for patellofemoral pain
Predicting if foot orthoses will help in patellofemoral pain
Foot orthoses and patellofemoral pain syndrome
Patella tracking and patellofemoral pain syndrome
Does the tibia drive the foot or does the foot drive the tibia?
Knee abduction impulses and patellofemoral pain
Management of Patellofemoral Pain Syndrome

NewsBot · Aug 27, 2011

Foot biomechanics and initial effects of infrapatellar strap on gait parameters in patients with unilateral patellofemoral pain syndrome
Nilgun Beka et al
The Foot; Volume 21, Issue 3, September 2011, Pages 114-118

Background
There is limited information on the relationship between plantar foot pressure and patellofemoral pain syndrome (PFPS). In addition, there is not enough research on the effects of an infrapatellar strap on PFPS.

Objective
The aim of this study was to evaluate the immediate effects of an infrapatellar strap on dynamic pedabarography in patients with unilateral PFPS.

Methods
Clinical case control study design. 18 females subjects with unilateral PFPS were included in the study. Gait parameters were tested using pedabarography during barefoot walking with and without an infrapatellar strap.

Results
There were no statistically significant differences in gait trials comparing infrapatellar strap to no strap (P > 0.05). In addition, a significant difference (P = 0.043) in the % forefoot surface on the involved side demonstrated that body weight is transferred to medial aspect of the foot.

Discussion
Although our results show a difference between the forefoot surface % of the affected and unaffected sides of subjects with PFPS there was no indication that an infrapatellar strap had any immediate effect on this parameter.

Conclusion
It is not clear whether PFPS is a cause or effect of abnormal gait. Further research is warranted to investigate the long-term effects of wearing an infrapatellar strap and associated altered foot biomechanics due to PFPS.
Click to expand...

NewsBot · Mar 25, 2014

Increased medial foot loading during drop jump in subjects with patellofemoral pain.
Rathleff MS, Richter C, Brushøj C, Bencke J, Bandholm T, Hölmich P, Thorborg K.
Knee Surg Sports Traumatol Arthrosc. 2014 Mar 22.

PURPOSE:
To compare medial-to-lateral plantar forces during drop jump and single leg squat in individuals with and without patellofemoral pain.
METHODS:
This cross-sectional study compared 23 young adults with patellofemoral pain to 20 age- and sex-matched controls without knee pain. The plantar pressure distribution was collected during drop jump and single leg squat using pressure-sensitive Pedar insoles, inserted into a standard flat shoe. The primary outcome was the medial-to-lateral force, quantified as the peak force under the medial forefoot as the percentage of force under the total forefoot during drop jump. Secondary outcomes included peak medial-to-lateral force during single leg squat and mean forces during drop jump and single leg squat.
RESULTS:
The primary outcome showed that individuals with patellofemoral pain had a 22 % higher medial-to-lateral peak force during drop jump, (p = 0.03). Secondary outcomes showed 32 % higher medial-to-lateral peak force during single leg squat (p = 0.01) and 19-23 % higher medial-to-lateral mean force during drop jump and single leg squat (p = 0.02-0.04).
CONCLUSION:
These findings indicate that individuals with patellofemoral pain display a more medially oriented loading pattern of the forefoot compared to individuals without knee pain. This loading pattern may be associated with the distribution of forces acting on the patellofemoral joint and suggest treatment of PFP should consider interventions that target normalisation of foot loading
Click to expand...

NewsBot · Feb 16, 2015

Plantar Loading Characteristics During Walking in Females With and Without Patellofemoral Pain.
John D. Willson, Eric D. Ellis, and Thomas W. Kernozek
Journal of the American Podiatric Medical Association: January 2015, Vol. 105, No. 1, pp. 1-7.

Background: Patellofemoral pain (PFP) is a common injury, particularly in females. Foot pronation may promote knee and hip transverse plane joint kinematics during gait thought to contribute to PFP. Greater knowledge of plantar loading characteristics in females with PFP may be valuable to provide a basis for clinical decisions regarding footwear and foot orthoses. The purpose of this study was to compare plantar loading distribution in females with and without PFP during gait.

Methods: Plantar pressure during walking was recorded from 19 females with PFP and 20 females without PFP. Contact area, peak force, and force-time integral were evaluated in ten plantar areas. Arch index was also calculated from contact area data during gait.

Results: Contact area in females with PFP was 9% smaller in the first metatarsal region (P = .039) and 20% smaller in the midfoot region (P = .042) than in females without PFP. Peak force was 31% lower in the midfoot region for females with PFP (P = .027) and 13% lower in the first metatarsal region (P = .064). Force-time integral was 18% lower in the first metatarsal region in females with PFP (P = .024). Females with PFP demonstrated a lower arch index (suggesting a higher arch) (P = .028).

Conclusions: Decreased medial forefoot loading and decreased midfoot contact suggest decreased foot pronation during gait in females with PFP relative to females without PFP. Decreased foot pronation may foster increased patellofemoral joint loading rates. These data contribute to rationale for footwear modifications to modify plantar loading characteristics in people experiencing PFP.
Click to expand...

Craig Payne · Feb 16, 2015

NewsBot said: ↑

Increased medial foot loading during drop jump in subjects with patellofemoral pain.
Rathleff MS, Richter C, Brushøj C, Bencke J, Bandholm T, Hölmich P, Thorborg K.
Knee Surg Sports Traumatol Arthrosc. 2014 Mar 22.
Click to expand...

CONCLUSION:
These findings indicate that individuals with patellofemoral pain display a more medially oriented loading pattern of the forefoot compared to individuals without knee pain.
Click to expand...

NewsBot said: ↑

Plantar Loading Characteristics During Walking in Females With and Without Patellofemoral Pain.
John D. Willson, Eric D. Ellis, and Thomas W. Kernozek
Journal of the American Podiatric Medical Association: January 2015, Vol. 105, No. 1, pp. 1-7.
Click to expand...

Conclusions:
Decreased medial forefoot loading and decreased midfoot contact suggest decreased foot pronation during gait in females with PFP relative to females without PFP.
Click to expand...

...go figure!

Dananberg · Feb 22, 2015

To me, decreased forefoot loading seems link a highly inverted foot position during walking or running. With this type of foot, inadequate 1st ray loading indicates an elevated position consistent with a Functional hallux limits. Pronation then occurs with heel off, causing the tibia to internally rotate while the femur is being externally rotated by pelvic motion. Knee joint gets caught in the middle.

Howard

NewsBot · Nov 19, 2016

Effect of Custom-Made Insole Fabricated With Medial Heel Skive Technique on Plantar Pressure in Individuals With Patellofemoral Pain Syndrome.
Aminian G R, Bahramian F, Bagherzadeh M, Fardipour S, Safaeipour Z, Abedian Avval A. Research Paper:
RJ. 2016; 17 (3) :0-0

Objective Knee problems, particularly patellofemoral pain syndrome (PFPS), are one of the common complaints of adolescents and young adults. PFPS is also known as "runner's knee" or "jumper's knee" due to its high prevalence among sportspersons. Its symptoms can be aggravated by ascending and descending stairs, squatting, deep squatting, kneeling, prolonged sitting, standing up from sitting, and running. Hence, it affects many aspects of daily life, including the ability to perform pain-free exercise or work-related activities. Non-surgical treatments such as physiotherapy, insoles, and knee orthoses are commonly used to treat people with PFPS. Insoles with medial heel skive is a new method of insole modification that can control pronation and involves the selective removal of small amounts of medial plantar heel of the positive cast of the foot.
The aim of this study is to evaluate the effects of custom-made insole with medial heel skive technique on plantar pressure in PFPS subjects.
Materials & Methods In this controlled before-after study, 14 subjects with PFPS were recruited. Plantar pressure and contact area in eight areas of the foot with and without insole with medial heel skive technique were measured using the Pedar system. A paired t-test was used for statistical analysis.
Results The results of this study showed that the use of insole with medial heel skive technique resulted in decreased plantar pressure in the medial hind foot (P=0.001) compared to without insole. Also, the average plantar pressure (P=0.003) and contact area (P=0.002) in the medial mid-foot with the insole with medial heel skive significantly increased in comparison to without insole. However, no significant change was observed in other regions.
Conclusion The above-mentioned insoles managed to control pronation and alter plantar pressure distribution. However, since the insoles simply transferred the pressure from one area to another area and failed to distribute the pressure equitably over the examined regions, they cannot be considered to have improved plantar pressure distribution in patients with PFPS.
Click to expand...

Craig Payne · Nov 19, 2016

dumb

NewsBot said: ↑

Effect of Custom-Made Insole Fabricated With Medial Heel Skive Technique on Plantar Pressure in Individuals With Patellofemoral Pain Syndrome.
Click to expand...

1. did they even have foot types in which a medial skive was indicated? (we don't know; but the authors appear to have no idea what the indication for a medical skive is!)

NewsBot said: ↑

However, since the insoles simply transferred the pressure from one area to another area and failed to distribute the pressure equitably over the examined regions, they cannot be considered to have improved plantar pressure distribution in patients with PFPS.
Click to expand...

2. Since when is "distribute the pressure equitably over the examined regions" a desirable outcome of foot orthotics in patellofemoral pain? (if you want to alter kinetics/kinematics at the knee I would have thought and 'inequitable' distribution of plantar pressures would be needed to achieve it)

NewsBot · Mar 22, 2019

Alterations in center of pressure during single limb loading in individuals with patellofemoral pain.
Craig R Gwynne
Journal of the American Podiatric Medical Association In-Press.

BACKGROUND:Altered foot loading during weight bearing is suggested to play a role in the development of patellofemoral pain (PFP). This study aimed to determine foot loading characteristics associated with PFP by assessing center of pressure (COP) during single limb loading in individuals with PFP compared to non-injured controls.

METHODS:Thirty recreationally active subjects with PFP and 30 non-injured controls had barefoot plantar pressure assessed during single limb squats (SLS) from which, COP parameters (COP velocity and COP index [COPI]) were obtained. Groups were compared using independent t-tests.

RESULTS:Individuals with PFP demonstrated greater COPI (P = .042), indicating a more lateral foot loading pattern and exhibited increased overall COP velocity (P = .013) and anterior-posterior COP velocity during SLS compared to controls (P = .033).

CONCLUSIONS:Greater lateral foot loading and increased COP velocity during SLS demonstrated by individuals with PFP may indicate reduced dynamic balance within this patient group, that may be implicated in the development of PFP.
Click to expand...

NewsBot · May 17, 2019

Increased Ground Reaction Force Load Rates In
Runners With Active Patellofemoral Pain
Caleb D. Johnson, Jereme Outerleys, Julia M. Reilly, Adam
S. Tenforde, Irene S. Davis
ACSM ANNUAL MEETING
May 28 – June 1, 2019 – Orlando, Florida

Increased vertical ground reaction force load rates have been associated with
running injuries, and specifically with tibial stress fractures and plantar fasciitis.
Inconsistent findings have been reported regarding the role of load rates in runners
with patellofemoral pain (PFP), one of the most common injuries in runners. Limited
studies in this patient population have been performed and prior investigators did not
examine components of load rates beyond the vertical component. PURPOSE: To
compare vertical, resultant, posterior, medial and lateral load rates, and peak vertical
forces in runners with active PFP to healthy controls. METHODS: 30 runners with
active PFP (16F, 14M, 40.2±12.8 yrs, 67.5±10.0 kg) and 30 healthy controls (CON)
(18F, 12M, 34.8±10.9 yrs, 70.4±14.0 kg), all habitual rearfoot strikers, completed an
instrumented treadmill assessment at a self-selected speed. Controls were matched for
speed (PFP=2.50 m/s, CON=2.51 m/s). Load rates (vertical average and instantaneous
(VALR, VILR), resultant instantaneous (RILR), posterior instantaneous (PILR),
medial instantaneous (MILR) and lateral instantaneous (LILR)) over the first 25% of
stance and normalized to bodyweights. Peak vertical ground reaction forces (vGRF)
were calculated over all of stance. Values were averaged across 10 consecutive
strides. The injured leg was analyzed for the PFP group, and the right/left leg was
randomly selected and counterbalanced for CON. RESULTS: Runners in the PFP
group showed significantly higher mean VALR (p=0.036, d=0.56), VILR (p= 0.040,
d=0.54) and RILR (p=0.036, d=0.55) than CON. No differences were found in PILR
(p=0.668), MILR (p=0.193), and LIRL (p=0.367) (Figure 1), or in peak vGRF (Mean
difference=0.03 BW, p=0.458). CONCLUSION: Runners with active PFP exhibit
higher vertical and resultant load rates.
Click to expand...

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Craig Payne Moderator

Dananberg Active Member

NewsBot The Admin that posts the news.

Craig Payne Moderator

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Plantar pressures and bone mineral density

Ranges of motion and plantar pressures

Deep learning algorithm for plantar pressures

Proximal influences on plantar pressures

Plantar pressures in twins

Plantar Pressures and Morton's Neuroma

Real Time Monitoring of Plantar Pressures

Share This Page