Acute Responses of Strength and Running Mechanics to Increasing and Decreasing Pain in Patients With Patellofemoral Pain.

Autor:	Bazett-Jones, David M., Huddleston, Wendy, Cobb, Stephen, O'Connor, Kristian, Earl-Boehm, Jennifer E.
Předmět:	PHYSIOLOGICAL adaptation ANALYSIS of variance CROSSOVER trials DYNAMICS GROUND reaction forces (Biomechanics) RANGE of motion of joints KINEMATICS MUSCLE strength PROBABILITY theory RUNNING STATISTICS TRANSCUTANEOUS electrical nerve stimulation DATA analysis EFFECT sizes (Statistics) PAIN measurement VISUAL analog scale REPEATED measures design PLICA syndrome SEVERITY of illness index MOTION capture (Human mechanics) DATA analysis software DESCRIPTIVE statistics MANN Whitney U Test
Zdroj:	Journal of Athletic Training (Allen Press); May2017, Vol. 52 Issue 5, p411-421, 11p, 1 Black and White Photograph, 1 Diagram, 5 Charts
Abstrakt:	Context: Patellofemoral pain (PFP) is typically exacerbated by repetitive activities that load the patellofemoral joint, such as running. Understanding the mediating effects of changes in pain in individuals with PFP might inform injury progression, rehabilitation, or both. Objective: To investigate the effects of changing pain on muscular strength and running biomechanics in those with PFP. Design: Crossover study. Setting: University research laboratory. Patients or Other Participants: Seventeen participants (10 men, 7 women) with PFP. Intervention(s): Each participant completed knee painreducing and pain-inducing protocols in random order. The pain-reducing protocol consisted of 15 minutes of transcutaneous electric nerve stimulation (TENS) around the patella. The pain-inducing protocol was sets of 20 repeated single-legged squats (RSLS). Participants completed RSLS sets until either their pain was within at least 1 cm of their pain during an exhaustive run or they reached 10 sets. Main Outcome Measure(s): Pain, isometric hip and trunk strength, and running mechanics were assessed before and after the protocols. Dependent variables were pain, normalized strength (abduction, extension, external rotation, lateral trunk flexion), and peak lower extremity kinematics and kinetics in all planes. Pain scores were analyzed using a Friedman test. Strength and mechanical variables were analyzed using repeated-measures analyses of variance. The a level was set at P , .05. Results: Pain was decreased after the TENS (pretest: 3.10 ± 1.95, posttest: 1.89 ± 2.33) and increased after the RSLS (baseline: 3.10 ± 1.95, posttest: 4.38 ± 2.40) protocols (each P < .05). The RSLS protocol resulted in a decrease in hipextension strength (baseline: 0.355 ± 0.08 kg/kg, posttest: 0.309 ± 0.09 kg/kg; P < .001). Peak plantar-flexion angle was decreased after RSLS (baseline: -13.97° ± 6.41°, posttest: -12.84° ± 6.45° P = .003). Peak hip-extension (pretest: -2.31 ± 0.46) and hip-abduction (pretest: -2.02 ± 0.35) moments decreased after both the TENS (extension: -2.15 ± 0.48 Nm/ kg, P = .015; abduction: -1.91 ± 0.33 Nm/kg, P = .015) and RSLS (extension: -2.18 ± 0.52 Nm/kg, P = .003; abduction: -1.87 ± 0.36 Nm/kg, P = .039) protocols. Conclusions: This study presents a novel and effective method of increasing pain in persons with PFP. Functionally increased pain after RSLS coincides with reduced hipextensor muscle strength and decreased plantar-flexion angle during running. The TENS treatment decreased pain during running in those with PFP but failed to influence strength. Hip moments were reduced by both protocols, which may demonstrate that acute increases or decreases in pain cause runners to change their mechanics. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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