Asymmetry in hip, knee and ankle kinematics in cyclists with chronic unilateral patellofemoral pain
Thesis (MScPhysio)--Stellenbosch University, 2016.
ENGLISH ABSTRACT: Background: Cycling has grown in popularity over the last number of years and the nature of the sport has led to a high incidence of overuse injuries such as patellofemoral pain (PFP). With patellofemoral pain being multifactorial numerous aspects have been investigated. In an attempt to further investigate contributing factors, asymmetry of joint kinematics in the lower limb has been investigated. Kinematics of the hip, knee and ankle joints in the sagittal, coronal and transverse plane were evaluated. Aim: The aim of this study was to investigate whether asymmetry of hip, knee and ankle kinematics in cyclists could contribute to patellofemoral pain when compared with cyclist without knee pain. Study Design: Descriptive study design was incorporated. Study Setting: This study was conducted at the FNB -3D motion analysis laboratory at the University of Stellenbosch, South Africa. Method: Road cyclists were recruited in South Africa and Namibia. The study sample comprised of seven road cyclists (4 with PFP and 3 without pain) who were evaluated at the FNB Motion Analysis Laboratory at Stellenbosch University. The Vicon Motion Systems (Ltd) (Oxford, UK) was used to capture three-dimensional joint kinematics. Collected data was utilised to draw graphs for visual comparison. Results: In the sagittal plane no asymmetry was noted in the hip and knee movement, but asymmetry was present in the ankle joint. However the asymmetry was present for both asymptomatic and symptomatic groups. In the coronal and transverse plane asymmetry was present in all joints; both the asymptomatic and symptomatic group presented some level of asymmetry. Conclusion: Asymmetry was apparent in the hip, knee and ankle joints in the coronal and the transverse plane, however it is present in the symptomatic as well as in the asymptomatic group and could therefore not be identified as a contributing factor for the development of patellofemoral pain. These findings highlight the fact that PFP is multifactorial and that all possible contributing factors should be kept in mind when evaluating and treating cyclists with PFP.
AFRIKAANSE OPSOMMING: Agtergrond: Fietsry het oor die afgelope paar jaar in populariteit gegroei, en die aard van die sport het gelei tot ‘n groot hoeveelheid oorgebruik beserings, soos patellofemorale pyn (PFP). Aangesien patellofemorale pyn menigvuldige bydraende faktore het, is verskeie aspekte reeds ondersoek. In ‘n poging tot verdere ondersoek rakende bydraende faktore, was asimmetrie kinematika van die heup, knie en enkel bewegings in die sagitale, koronale en transverse vlakke geevalueer. Doelstellings: Die doel van die studie was om te bepaal of asimmetrie van die heup, knie en enkel kinemetika in fietsryes ‘n bydraende factor kan wees tot die ontwikkeling van patellofemorale pyn wanneer hulle vergelyk word met fietsryers sonder knie pyn. Studie: Beskrywende studie. Metode: Padfietsryers is in Suid-Afrika en Namibia gewerf. ‘n Totaal van sewe padfietsryers (4 met patellofemorale pyn en 3 sonder pyn) was by die FNB Bewegings Analise Laboratorium by Stellenbosch Universiteit geevalueer. Die Vicon Motion Systems (Ltd) (Oxford, UK) was gebruik om driedimensionele beweging van die gewrigte vas te vang. Die versamelde data was verwerk om grafieke te teken en sodoende visuele vergelykings te tref. Hoof Bevindinge en Interpretasie: Asimmetrie was duidelik in die koronale en transvers vlakke, maar is teenwoordig in beide die simptomatiese asook die asimptomatiese groepe en kon daarom nie geidentifiseer word as enigste bydraende faktor nie. Dit benadruk dat PFP menigvuldige bydraende faktore het en dat alle moontlike aspekte geevalueer en behandel moet word by fietsryers met PFP.