Lower Extremity Kinematics of Females With Patellofemoral Pain Syndrome While Stair Stepping
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STUDY DESIGN: Cross-sectional case-control design. BACKGROUND: Although the etiology of patellofemoral pain syndrome (PFPS) is not completely understood, there is some evidence to suggest that hip position during weight-bearing activities contributes to the disorder. OBJECTIVE: To compare the knee and hip motions (and their coordination) during stair stepping in female athletes with and without PFPS. METHODS: Two groups of female recreational athletes, 1 group with PFPS (n = 10) and a control group without PFPS (n = 10), were tested. All participants ascended and descended stairs (condition) at 2 speeds (self-selected comfortable and taxing [defined as 20% faster than the comfortable speed]), while the knee and hip angles were measured with a magnetic-based kinematic data acquisition system. Angle-angle diagrams were used to examine the relationship between flexion/extension of the knee and flexion/extension, adduction/abduction, and internal/external rotation of the hip. The angle of the knee and the 3 angles of the hip at foot contact on the third step were compared between groups by means of 3-way analyses of variance (ANOVA), with repeated measures on speed and condition. RESULTS: Group-by-speed interaction for knee angle was significant, with knee flexion being greater for the PFPS group for stair ascent and descent at a comfortable speed. Both the angle-angle diagrams and ANOVA demonstrated greater adduction and internal rotation of the hip in the individuals with PFPS compared to control participants during stair descent. CONCLUSION: Compared to control participants, females with PFPS descend stairs with the knee in a more flexed position and have the hip in a more adducted and internally rotated position at foot contact during stair stepping at a comfortable speed.