Understanding the biomechanical risk factors ofpatellofemoral pain (PFP) in military individuals
Year: 2018
Type: dissertation
Study design: Observational Study
Abstract: Patellofemoral pain (PFP) is one of the major sources of chronic knee pain in young athletes, \naffecting one in four individuals. To progress further in this field, prospective studies are \ntherefore needed in order to gain a better understanding of the biomechanical risk factors of \nPFP and to develop future treatment and prevention strategies. With this in mind, the main \npurpose of the present PhD thesis is to prospectively examine individuals’ lower limb \nmovements with two-dimensional (2D) video analysis and muscle strength with a handheld \ndynamometer (HHD) in order to screen for PFP development, in addition to other lower limb \ninjuries. Therefore, a systematic review and meta- analysis in addition to three studies were \nconducted within this thesis to investigate the factors involved in the development of PFP. \n In the first study, 15 healthy subjects (6 male and 9 female) participated in a reliability study \n(within-day, between-day, intra-rater, and inter-rater reliability) of 2D frontal plane projection \nangle (FPPA) and hip adduction (HADD) angle. They also participated in a validation study \nfor 2D motion analysis against the gold standard of three-dimensional (3D) motion analysis. \nIn the second study, eight healthy male subjects participated in a between-day reliability and \nvalidity study for 2D analysis and HHD strength tests against the gold standard of 3D analysis, \nusing Qualysis Track Manager (QTM) system and an isokinetic dynamometer for the \nmeasurements of lower limb kinematics (FPPA, Q-angle, HADD, knee flexion, ankle \ndorsiflexion, and rearfoot angle) and strength (hip abductors and knee extensors). The main \nstudy was undertaken with 315 healthy male infantry cadets and recruits from King Abdul- \nAziz Military Academy (KAMA) and two other basic military training centres in Saudi Arabia. \nLower limb kinematics and muscle strength were measured during running (RUN), single leg \nsquatting (SLS), and single leg landing (SLL) in the first week of training, and were followed \nup over the participants’ 12 weeks of basic military training for the occurrence of PFP and \nother lower limb injuries. \n Participants who developed PFP had a significantly greater FPPA and Q-angle during SLS, \nSLL, and RUN, as well as a significantly greater HADD during SLS and SLL, than participants \nwho did not develop PFP. In addition, the injured group had significantly lower knee extensor \nand hip abductor muscle strength during the baseline assessment when compared to the noninjured \ngroup. The logistic regression revealed that FPPA during SLL significantly predicts the \ndevelopment of PFP. Therefore, this appears to be a suitable method for screening of PFP risk \nbefore joining basic military training.
Author: Hasan Alrayani
Language: English
Subfield: Biomedical Engineering
Field: Engineering
Domain: Physical Sciences
Open Access status: green
OpenAlex ID: W2895390536