Correlation between Dorsiflexion Ankle Range of Motion and Patellofemoral Pain Syndrome
DOI:
https://doi.org/10.17921/2447-8938.2018v20n2p135-139Resumo
Abstract
The change in lower extremity movement pattern has been previously associated with severe knee disorders, including anterior cruciate ligament rupture, patellar tendinopathy, iliotibial band syndrome, and patellofemoral pain (PFP). The aim of this study was to verify the clinical reliability of ankle dorsiflexion range of motion (ADROM) measurement with weight bearing (WB) using an app on the smartphone (iHand) and to verify if there is correlation between the limitation of the ADROM and the PFP. A total of 67 women, mean age 34.3 ± 2.4, height 182 ± 3.6, weight 73.7 ± 4.2, were allocated to the control group (n = 23) and the PFP group (n = 23). Two examiners evaluated the active ADROM (lunge test) in both ankles at two times to test inter-examiner and intra-examiner reliability. It was observed in the PFP group that the mean ADROM was 17.7 ± 2.5 and the control group was 35.3 ± 6.2 (right) and 17.1 ± 2.9 and 32.9 ± 5, 4 (left). It is concluded that the use of the smartphone app proved to be reliable for clinical application in the evaluation of ADROM with WB and that there is a relation between the low DFT of DFT with the presence of patellofemoral pain.
Keywords: Data Accuracy. Ankle. Patellofemoral Pain Syndrome.
Resumo
A alteração no padrão de movimento da extremidade inferior tem sido previamente associada com severas desordens do joelho, incluindo a ruptura do ligamento cruzado anterior, tendinopatia patelar, síndrome da banda iliotibial e dor patelofemoral - DPF. O objetivo do estudo foi verificar a confiabilidade clínica da mensuração da dorsiflexão de tornozelo - DFT com descarga de peso - WB utilizando um app no smartphone (iHand) e verificar se há correlação entre a limitação da DFT com a DPF. Participaram 67 mulheres, idade média 34,3±2,4, altura 182±3,6, peso 73,7±4,2, alocadas em grupo controle (n=23) e grupo DFP (n=23). Dois examinadores avaliaram a DFT ativa (lunge test) em ambos os tornozelos em dois momentos para se testar a confiabilidade inter-examinador e intra-examinador. O coeficiente de correlação intraclasse - CCI foi utilizado para a análise da confiabilidade das medidas. Observou-se alta confiabilidade (0,9965 [p<0,0001]) e (0,9949 [p<0,0001]) para tornozelo direito e esquerdo respectivamente. Observou-se no grupo DFP que a ADM média de DFT foi de 17,7±2,5 e grupo controle de 35,3±6,2 (direito) e 17,1±2,9 e 32,9±5,4 (esquerdo). Conclui-se que a utilização do app de smartphone se mostrou confiável para aplicação clínica na avaliação da DFT com WB e que há relação entre a baixa ADM de DFT com a presença de dor patelofemoral.
Palavras-chave: Acurácia dos Dados. Tornozelo. Síndrome da Dor Patelofemoral
Referências
Bisseling RW, Hot AL, Bredeweg SW, Zwerver J, Mulde T. Are the take-off and landing phase dynamics of the volleyball spike jump related to patellar tendinopathy? Br J Sports Med 2008;42(6):483-9.
Boling MC, Padua DA, Marshall SW, Guskiewicz K, Pyne S, Beutler A. A Prospective Investigation of Biomechanical Risk Factors for Patellofemoral Pain Syndrome. Am J Sports Med 2009;37(11):2108-16.
Noehren B, Pohl MB, Sanchez Z, Cunningham T, Lattermann C. Proximal and distal kinematics in female runners with patellofemoral pain. Clin Biomech 2012;27(4):366-71. doi: http://dx.doi.org/10.1016/j.clinbiomech.2011.10.005
Edwards S, Steele JR, McGhee DE, Beattie S, Purdam C, Cook JL. Landing strategies of athletes with an asymptomatic patellar tendon abnormality. Med Sci Sports Exerc 2010;42(11):2072-80.
Hewett TE, Myer GD, Ford KR, Heidt RS, Colosimo AJ, Mclean SG, et al. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes a prospective study biomechanical measures of neuromuscular control and valgus loading of the knee predict ant. Am J Sport Med 2005;33(4):492-501.
Mann K, Edwards S. Movement screening tool identifying athletes at risk of developing patellar tendinopathy. ISBS-Conference 2012;(200):35-8.
Nakagawa TH. Trunk, pelvis, hip, and knee kinematics, hip strength, and gluteal muscle activation during a single leg squat in males and females with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther 2012;42(6):491-501. doi: 10.2519/jospt.2012.3987.
Silva P, Lott R, Wickrama KS, Mota J, Welk G. Note: this article will be published in a forthcoming issue of the Journal of Physical Activity & Health . This article appears here in its accepted , peer-reviewed form ; it has not been copy edited , proofed , or formatted by the publisher . Psychosoci. Int J Sport Nutr Exerc Metab 2011;32:1-44.
Souza RB, Powers CM. Differences in hip kinematics, muscle strength, and muscle activation between subjects with and without patellofemoral pain. J Orthop Sports Phys Ther 2009;39(1):12-9.
Lachmann S. Patellofemoral arthralgia in athletes attending a Sports Injury. Brit J Sport Med 1984;18(1):18-21.
Lopes AD, Hespanhol LC, Yeung SS, Pena Costa LO. What are the Main running related musculoskeletal injuries. Sport Med 2012;42(10):892-905.
Tauton J, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR ZB. A retrospective case-control analysis of 2002 running injuries. Sport Med. 2002;95-102.
Barton CJ, Lack S, Malliaras P, Morrissey D. Gluteal muscle activity and patellofemoral pain syndrome: a systematic review. Br J Sport Med 2013;47:207-14.
Bertelsen ML, Jensen JF, Nielsen MH, Nielsen RO, Rasmussen S. Footstrike patterns among novice runners wearing a conventional, neutral running shoe. Gait Posture 2013;38(2):354-6. doi: http://dx.doi.org/10.1016/j.gaitpost.2012.11.022
Witvrouw E, Callaghan MJ, Stefanik JJ, Noehren B, Bazett-Jones DM, Willson JD, et al. Patellofemoral pain: consensus statement from the 3rd International Patellofemoral Pain Research Retreat held in Vancouver, September 2013. Br J Sports Med 2014;48(6):411-4. doi: http://bjsm.bmj.com/lookup/doi/10.1136/bjsports-2014-093450
Davis IS, Powers CM. Patellofemoral Pain syndrome: proximal, distal, and local factors: international research retreat 2009. J Orthop Sport Phys Ther 2010;40(3):A1-48.
Powers CM, Bolgla L, Callaghan MJ, Collins N, Sheehan FT. Patellofemoral pain: proximal, distal, and local factors, 2nd international research retreat. J Orthop Sports Phys Ther 2012:1-55
Dill KE, Begalle RL, Frank BS, Zinder SM, Padua DA. Altered knee and ankle kinematics during squatting in those with limited weight-bearing-lunge ankle-dorsiflexion range of motion. J Athl Train 2014;49(6):723-32. doi: 10.4085/1062-6050-49.3.29.
Fong CM, Blackburn JT, Norcross MF, McGrath M, Padua DA. Ankle-dorsiflexion range of motion and landing biomechanics. J Athl Train 2011;46(1):5-10.
Malloy P, Morgan A, Meinerz C, Geiser C, Kipp K. The association of dorsiflexion flexibility on knee kinematics and kinetics during a drop vertical jump in healthy female athletes. Knee Surg Sport Traumatol Arthrosc 2015;23(12):3550–5. doi: 10.1007/s00167-014-3222-z.
Sigward SM, Ota S, Powers CM. Predictors of frontal plane knee excursion during a drop land in young female soccer players. J Orthop Sports Phys Ther 2008;38(11):661-7.
Rabin A. Measures of Range of Motion and Strength Among Healthy Women With Differing Quality of Lower Extremity Movement During the Lateral Step-Down Test. 2010;40(12):792–800.
Hoch MC, McKeon PO. Normative range of weight-bearing lunge test performance asymmetry in healthy adults. Man Ther 2011;16(5):516-9. doi: http://dx.doi.org/10.1016/j.math.2011.02.012
Konor MM, Morton S, Eckerson JM, Grindstaff TL. Reliability of three measures of ankle dorsiflexion range of motion. Int J Sports Phys Ther 2012;7(3):279-87.
Venturini C, Ituassú N, Teixeira L, Deus C. Confiabilidade intra e interexaminadores de dois métodos de medida da amplitude ativa de dorsiflexão do tornozelo em indivíduos saudáveis. Rev Bras Fisioter 2006;10(4):407-11.
Johanson M, Baer J, Hovermale H, Phouthavong P. Subtalar joint position during gastrocnemius stretching and ankle dorsiflexion range of motion. J Athl Train 2008;43(2):172-8.
Rabin A, Kozol Z, Spitzer E, Finestone AS. Weight-bearing ankle dorsiflexion range of motion-can side-to-side symmetry be assumed? J Athl Train 2015;50(1):30-5.
Mascal CL, Landel R, Powers C. Mannernent of patellofernoral pain targeting hip, pelvis, and trunk muscle function: 2 case reports. J Orthop Sport Phys Ther 2003;33(11):647-60.
Bell-Jenje T, Olivier B, Wood W, Rogers S, Green A, McKinon W. The association between loss of ankle dorsiflexion range of movement, and hip adduction and internal rotation during a step down test. Man Ther 2016;21:256-61. doi: 10.1016/j.math.2015.09.010.
Nakagawa TH, Maciel CD, Serrão FV. Trunk biomechanics and its association with hip and knee kinematics in patients with and without patellofemoral pain. Man Ther. 2015;20(1):189-93. doi: 10.1016/j.math.2014.08.013.
Vohralik SL, Bowen AR, Burns J, Hiller CE, Nightingale EJ. Reliability and Validity of a Smartphone App to Measure Joint Range. Am J Phys Med Rehabil 2014;325-30. doi: 10.1097/PHM.0000000000000221.
Pourahmadi MR, Taghipour M, Jannati E, Mohseni-Bandpei MA, Ebrahimi Takamjani I, Rajabzadeh F. Reliability and validity of an iPhone(®) application for the measurement of lumbar spine flexion and extension range of motion. Peer J 2016;4:e2355. doi: 10.7717/peerj.2355.
Larsen P, Nielsen HB, Lund C, Sørensen DS, Larsen BT, Matthews M, et al. A novel tool for measuring ankle dorsiflexion: a study of its reliability in patients following ankle fractures. Foot Ankle Surg 2016;2(4):274-7. doi: 10.1016/j.fas.2016.01.008.
Calatayud J, Martin F, Gargallo P, García-Redondo J, Colado JC, Marín PJ. The validity and reliability of a new instrumented device for measuring ankle dorsiflexion range of motion. Int J Sports Phys Ther 2015;10(2):197-202.
Rabin A. Portnoy S, Kozol Z. The Association of Ankle Dorsiflexion Range of Motion With Hip and Knee Kinematics During the Lateral Step-down Test. J Orthop Sports Phys Ther 2016;46(11):1002-9. doi: 10.2519/jospt.2016.6621
Willson JD, Davis IS. Utility of the frontal plane projection angle in females with patellofemoral pain. J Orthop Sports Phys Ther 2008;38(10):606-15.
Malliaras P, Cook JL, Kent P. Reduced ankle dorsiflexion range may increase the risk of patellar tendon injury among volleyball players. J Sci Med Sport 2006;9(4):304-9.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Os autores devem ceder expressamente os direitos autorais à Kroton Educacional, sendo que a cessão passa a valer a partir da submissão do artigo, ou trabalho em forma similar, ao sistema eletrônico de publicações institucionais. A revista se reserva o direito de efetuar, nos originais, alterações de ordem normativa, ortográfica e gramatical, com vistas a manter o padrão culto da língua, respeitando, porém, o estilo dos autores. As provas finais serão enviadas aos autores. Os trabalhos publicados passam a ser propriedade da Kroton Educacional, ficando sua reimpressão total ou parcial, sujeita à autorização expressa da direção da Kroton Educacional. O conteúdo relatado e as opiniões emitidas pelos autores dos artigos são de sua exclusiva responsabilidade.
