Greater Contralateral Pelvic Drop Research Articles

Females with hip pain walk with altered kinematics at peaks and throughout the gait cycle

BackgroundFemales with acetabular dysplasia and/or labral tears (hip pain) exhibit altered walking kinematics, with studies reporting mixed results in sagittal and frontal planes compared to pain-free controls, often conducting only discrete analyses and warranting further investigation. The objective of this study was to investigate discrete and continuous hip and pelvic kinematics between females with and without hip pain in two walking conditions. MethodsWe collected kinematic walking data from 69 females (35 with hip pain, 34 controls) using motion capture and an instrumented treadmill in two conditions: preferred and fast (125% preferred). We used a general linear model and one-dimensional statistical parametric mapping to conduct discrete and continuous analyses comparing kinematics between groups, with and without adjustment for gait speed. FindingsThe hip pain group walked with reduced peak hip extension (Preferred: P = .046, Cohen's d = 0.41; Fast: P = .028, d = 0.48) and greater peak anterior pelvic tilt (Preferred: P = .011, d = 0.57; Fast: P = .012, d = 0.58) compared to controls. From continuous analyses, the hip pain group walked with reduced hip extension during terminal stance (Fast: P = .040), greater anterior pelvic tilt throughout (Preferred: P = .007; Fast: P = .004), and greater contralateral pelvic drop (Preferred: P = .045) during midstance. Adjusting for speed slightly affected p-values, but significance was retained for all prior variables except pelvic drop. InterpretationKinematic differences between individuals with and without hip pain may provide insight into potential predisposing factors for hip pathology and/or compensations for pain or pathological processes. This work furthers understanding of altered movement patterns in individuals with hip pain and may inform physical therapy treatments.

Relationship between kinesiophobia, isometric hip and knee torques to pelvic, hip and knee motion during the single-leg drop jump in women with patellofemoral pain: A cross-sectional study

BackgroundIndividuals with patellofemoral pain (PFP) have kinesiophobia and hip and knee strength deficits. These factors may be related to kinematic alterations of pelvic, hip and knee during a more demanding functional activity, such as jumping landing. The aim was to investigate the relationships between kinesiophobia and hip/knee torque to pelvic/hip/knee kinematics during the single-leg drop vertical jump in women with PFP. MethodThirty women with PFP were assessed with Tampa Scale for Kinesiophobia; isokinetic dynamometry of the hip extensor, hip abductor, and knee extensor; and three-dimensional motion analysis system during the single-leg drop vertical jump. A Pearson correlation matrix was used to investigate relationship among variables. ResultsFair correlations were found between increased kinesiophobia and increased peak hip internal rotation angle (r = 0.43; p = 0.018) as well as between greater peak knee extensor torque and greater peak knee flexion (r = 0.41; p = 0.022). Moderate to good correlation was found between increased peak hip abductor torque and increased peak contralateral pelvic drop (r = 0.52; p = 0.003). No other significant correlations were found between variables. ConclusionsKinesiophobia is associated with hip kinematics, but not with knee kinematics, during the single-leg vertical drop jump in women with PFP. The greater hip abductor torque is associated with greater contralateral pelvic drop. The positive relationship between knee extensor torque and knee flexion indicates that rehabilitation programs involving quadriceps muscle strengthening may assist women with PFP in control knee flexion and improve load absorption during jumping landing.

Kinematic and Kinetic Gait Characteristics in People with Patellofemoral Pain: A Systematic Review and Meta-analysis.

Patellofemoral pain (PFP) is a prevalent knee condition with many proposed biomechanically orientated etiological factors and treatments. We aimed to systematically review and synthesize the evidence for biomechanical variables (spatiotemporal, kinematic, kinetic) during walking and running in people with PFP compared with pain-free controls, and determine if biomechanical variables contribute to the development of PFP. Systematic review and meta-analysis. We searched Medline, CINAHL, SPORTDiscus, Embase, and Web of Science from inception to October 2021. All study designs (prospective, case-control [± interventional component, provided pre-intervention data were reported for both groups], cross-sectional) comparing spatiotemporal, kinematic, and/or kinetic variables during walking and/or running between people with and without PFP. We identified 55 studies involving 1300 people with PFP and 1393 pain-free controls. Overall pooled analysis identified that people with PFP had slower gait velocity [moderate evidence, standardized mean difference (SMD) -0.50, 95% confidence interval (CI) -0.72, -0.27], lower cadence (limited evidence, SMD -0.43, 95% CI -0.74, -0.12), and shorter stride length (limited evidence, SMD -0.46, 95% CI -0.80, -0.12). People with PFP also had greater peak contralateral pelvic drop (moderate evidence, SMD -0.46, 95% CI -0.90, -0.03), smaller peak knee flexion angles (moderate evidence, SMD -0.30, 95% CI -0.52, -0.08), and smaller peak knee extension moments (limited evidence, SMD -0.41, 95% CI -0.75, -0.07) compared with controls. Females with PFP had greater peak hip flexion (moderate evidence, SMD 0.83, 95% CI 0.30, 1.36) and rearfoot eversion (limited evidence, SMD 0.59, 95% CI 0.03, 1.14) angles compared to pain-free females. No significant between-group differences were identified for all other biomechanical variables. Data pooling was not possible for prospective studies. A limited number of biomechanical differences exist when comparing people with and without PFP, mostly characterized by small-to-moderate effect sizes. People with PFP ambulate slower, with lower cadence and a shortened stride length, greater contralateral pelvic drop, and lower knee flexion angles and knee extension moments. It is unclear whether these features are present prior to PFP onset or occur as pain-compensatory movement strategies given the lack of prospective data. PROSPERO # CRD42019080241.

Running gait biomechanics in female runners with sacroiliac joint pain.

[Purpose] To identify running gait biomechanics associated with sacroiliac (SI) joint pain in female runners compared to healthy controls. [Participants and Methods] In this case-control study, treadmill running gait biomechanics of female runners diagnosed SI joint pain, (by ultrasound-guided diagnostic SI joint injection and/or ≥2 positive SI physical exam maneuvers) were compared with age, height, mass, and BMI matched healthy female runners. Sagittal and coronal plane treadmill running video angles were measured and compared. [Results] Eighteen female runners with SI pain, and 63 matched controls, were analyzed. There was no difference in age, height, mass, or BMI between groups. At the point of initial contact, runners with SI joint pain demonstrated less knee flexion, greater tibial overstride, and greater ankle dorsiflexion, compared to controls. In midstance, runners with SI pain had greater contralateral pelvic drop compared to controls. For unilateral SI joint pain cases (N=15), greater contralateral pelvic drop was observed when loading their affected side compared to the unaffected side. [Conclusion] Female runners with SI joint pain demonstrated greater contralateral pelvic drop during midstance phase; along with less knee flexion, greater “tibial overstride”, and greater ankle dorsiflexion at initial contact compared to controls.

Static Ankle Dorsiflexion and Hip and Pelvis Kinematics During Forward Step-Down in Patients With Hip-Related Groin Pain.

The authors hypothesized that in people with hip-related groin pain, less static ankle dorsiflexion could lead to compensatory hip adduction and contralateral pelvic drop during step-down. Ankle dorsiflexion may be a modifiable factor to improve ability in those with hip-related groin pain to decrease hip/pelvic motion during functional tasks and improve function. To determine whether smaller static ankle dorsiflexion angles were associated with altered ankle, hip, and pelvis kinematics during step-down in people with hip-related groin pain. Cross-sectional Setting: Academic medical center. A total of 30 people with hip-related groin pain (12 males and 18 females; 28.7 [5.3]y) participated. None. Weight-bearing static ankle dorsiflexion with knee flexed and knee extended were measured via digital inclinometer. Pelvis, hip, and ankle kinematics during forward step-down were measured via 3D motion capture. Static ankle dorsiflexion and kinematics were compared with bivariate correlations. Smaller static ankle dorsiflexion angles were associated with smaller ankle dorsiflexion angles during the step-down for both the knee flexed and knee extended static measures. Among the total sample, smaller static ankle dorsiflexion angle with knee flexed was associated with greater anterior pelvic tilt and greater contralateral pelvic drop during the step-down. Among only those who did not require a lowered step for safety, smaller static ankle dorsiflexion angles with knee flexed and knee extended were associated with greater anterior pelvic tilt, greater contralateral pelvic drop, and greater hip flexion. Among those with hip-related groin pain, smaller static ankle dorsiflexion angles are associated with less ankle dorsiflexion motion and altered pelvis and hip kinematics during a step-down. Future research is needed to assess the effect of treating restricted ankle dorsiflexion on quality of motion and symptoms in patients with hip-related groin pain.

Two-dimensional video analysis can discriminate differences in running kinematics between recreational runners with and without running-related knee injury

ObjectivesTo determine whether two-dimensional video analysis could discriminate running kinematics between recreational runners with and without a running-related knee injury. DesignCase-control. SettingResearch laboratory. ParticipantsForty-two recreational runners (5 male-13 female injured; 7 male-17 female non-injured). Running-related knee injury was defined as the presence of anterior or lateral knee pain, resulting in altered running activity for at least one week. Main outcome measuresFoot and tibia inclination at initial contact, and lateral trunk position, contralateral pelvic drop, femoral adduction, hip adduction, knee flexion and ankle dorsiflexion at midstance were measured with two-dimensional video analysis during running. Participant characteristics (sex, age, body weight, body length, body mass index, running volume before injury, running speed) and two-dimensional measured angles were compared between groups. ResultsNo significant differences in participant characteristics between groups were identified (P > .05). The injured group ran with greater contralateral pelvic drop (P = .035), femoral adduction (P = .021) and hip adduction (P = .001) at midstance, and significantly smaller foot inclination at initial contact (P = .031). ConclusionTwo-dimensional video analysis can discriminate kinematics between runners with and without running-related knee injury. Greater contralateral pelvic drop, femoral adduction and hip adduction at midstance may provide running retraining targets for runners with running-related knee injury.

Propulsion phase of the single leg triple hop test in women with patellofemoral pain syndrome: a biomechanical study.

Asymmetry in the alignment of the lower limbs during weight-bearing activities is associated with patellofemoral pain syndrome (PFPS), caused by an increase in patellofemoral (PF) joint stress. High neuromuscular demands are placed on the lower limb during the propulsion phase of the single leg triple hop test (SLTHT), which may influence biomechanical behavior. The aim of the present cross-sectional study was to compare kinematic, kinetic and muscle activity in the trunk and lower limb during propulsion in the SLTHT using women with PFPS and pain free controls. The following measurements were made using 20 women with PFPS and 20 controls during propulsion in the SLTHT: kinematics of the trunk, pelvis, hip, and knee; kinetics of the hip, knee and ankle; and muscle activation of the gluteus maximus (GM), gluteus medius (GMed), biceps femoris (BF) and vastus lateralis (VL). Differences between groups were calculated using three separate sets of multivariate analysis of variance for kinematics, kinetics, and electromyographic data. Women with PFPS exhibited ipsilateral trunk lean; greater trunk flexion; greater contralateral pelvic drop; greater hip adduction and internal rotation; greater ankle pronation; greater internal hip abductor and ankle supinator moments; lower internal hip, knee and ankle extensor moments; and greater GM, GMed, BL, and VL muscle activity. The results of the present study are related to abnormal movement patterns in women with PFPS. We speculated that these findings constitute strategies to control a deficient dynamic alignment of the trunk and lower limb and to avoid PF pain. However, the greater BF and VL activity and the extensor pattern found for the hip, knee, and ankle of women with PFPS may contribute to increased PF stress.