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The immediate effects of foot orthoses on hip and knee kinematics and muscle activity during a functional step-up task in individuals with patellofemoral pain.
Clin Biomech (Bristol, Avon). 2014 Nov; 29(9):1056-62.CB

Abstract

BACKGROUND

Evidence shows that anti-pronating foot orthoses improve patellofemoral pain, but there is a paucity of evidence concerning mechanisms. We investigated the immediate effects of prefabricated foot orthoses on (i) hip and knee kinematics; (ii) electromyography variables of vastus medialis oblique, vastus lateralis and gluteus medius during a functional step-up task, and (iii) associated clinical measures.

METHODS

Hip muscle activity and kinematics were measured during a step-up task with and without an anti-pronating foot orthoses, in people (n=20, 9 M, 11 F) with patellofemoral pain. Additionally, we measured knee function, foot posture index, isometric hip abductor and knee extensor strength and weight-bearing ankle dorsiflexion.

FINDINGS

Reduced hip adduction (0.82°, P=0.01), knee internal rotation (0.46°, P=0.03), and decreased gluteus medius peak amplitude (0.9mV, P=0.043) were observed after ground contact in the 'with orthoses' condition. With the addition of orthoses, a more pronated foot posture correlated with earlier vastus medialis oblique onset (r=-0.51, P=0.02) whilst higher Kujala scores correlated with earlier gluteus medius onset (r=0.52, P=0.02).

INTERPRETATION

Although small in magnitude, reductions in hip adduction, knee internal rotation and gluteus medius amplitude observed immediately following orthoses application during a task that commonly aggravates symptoms, offer a potential mechanism for their effectiveness in patellofemoral pain management. Given the potential for cumulative effects of weight bearing repetitions completed with a foot orthoses, for example during repeated stair ascent, the differences are likely to be clinically meaningful.

Authors+Show Affiliations

Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, England, United Kingdom.Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, England, United Kingdom.Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, England, United Kingdom.Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, England, United Kingdom.Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, England, United Kingdom. Electronic address: d.morrissey@qmul.ac.uk.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25441771

Citation

Lack, Simon, et al. "The Immediate Effects of Foot Orthoses On Hip and Knee Kinematics and Muscle Activity During a Functional Step-up Task in Individuals With Patellofemoral Pain." Clinical Biomechanics (Bristol, Avon), vol. 29, no. 9, 2014, pp. 1056-62.
Lack S, Barton C, Woledge R, et al. The immediate effects of foot orthoses on hip and knee kinematics and muscle activity during a functional step-up task in individuals with patellofemoral pain. Clin Biomech (Bristol, Avon). 2014;29(9):1056-62.
Lack, S., Barton, C., Woledge, R., Laupheimer, M., & Morrissey, D. (2014). The immediate effects of foot orthoses on hip and knee kinematics and muscle activity during a functional step-up task in individuals with patellofemoral pain. Clinical Biomechanics (Bristol, Avon), 29(9), 1056-62. https://doi.org/10.1016/j.clinbiomech.2014.08.005
Lack S, et al. The Immediate Effects of Foot Orthoses On Hip and Knee Kinematics and Muscle Activity During a Functional Step-up Task in Individuals With Patellofemoral Pain. Clin Biomech (Bristol, Avon). 2014;29(9):1056-62. PubMed PMID: 25441771.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The immediate effects of foot orthoses on hip and knee kinematics and muscle activity during a functional step-up task in individuals with patellofemoral pain. AU - Lack,Simon, AU - Barton,Christian, AU - Woledge,Roger, AU - Laupheimer,Markus, AU - Morrissey,Dylan, Y1 - 2014/08/23/ PY - 2014/04/30/received PY - 2014/08/13/revised PY - 2014/08/14/accepted PY - 2014/12/3/entrez PY - 2014/12/3/pubmed PY - 2015/10/8/medline KW - Electromyography KW - Kinematics KW - Onset times KW - Orthoses KW - Patellofemoral pain SP - 1056 EP - 62 JF - Clinical biomechanics (Bristol, Avon) JO - Clin Biomech (Bristol, Avon) VL - 29 IS - 9 N2 - BACKGROUND: Evidence shows that anti-pronating foot orthoses improve patellofemoral pain, but there is a paucity of evidence concerning mechanisms. We investigated the immediate effects of prefabricated foot orthoses on (i) hip and knee kinematics; (ii) electromyography variables of vastus medialis oblique, vastus lateralis and gluteus medius during a functional step-up task, and (iii) associated clinical measures. METHODS: Hip muscle activity and kinematics were measured during a step-up task with and without an anti-pronating foot orthoses, in people (n=20, 9 M, 11 F) with patellofemoral pain. Additionally, we measured knee function, foot posture index, isometric hip abductor and knee extensor strength and weight-bearing ankle dorsiflexion. FINDINGS: Reduced hip adduction (0.82°, P=0.01), knee internal rotation (0.46°, P=0.03), and decreased gluteus medius peak amplitude (0.9mV, P=0.043) were observed after ground contact in the 'with orthoses' condition. With the addition of orthoses, a more pronated foot posture correlated with earlier vastus medialis oblique onset (r=-0.51, P=0.02) whilst higher Kujala scores correlated with earlier gluteus medius onset (r=0.52, P=0.02). INTERPRETATION: Although small in magnitude, reductions in hip adduction, knee internal rotation and gluteus medius amplitude observed immediately following orthoses application during a task that commonly aggravates symptoms, offer a potential mechanism for their effectiveness in patellofemoral pain management. Given the potential for cumulative effects of weight bearing repetitions completed with a foot orthoses, for example during repeated stair ascent, the differences are likely to be clinically meaningful. SN - 1879-1271 UR - https://www.unboundmedicine.com/medline/citation/25441771/The_immediate_effects_of_foot_orthoses_on_hip_and_knee_kinematics_and_muscle_activity_during_a_functional_step_up_task_in_individuals_with_patellofemoral_pain_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0268-0033(14)00198-3 DB - PRIME DP - Unbound Medicine ER -