Ferreira Amanda Schenatto, de Oliveira Silva Danilo, Briani Ronaldo Valdir, Ferrari Deisi, Aragão Fernando Amâncio, Pazzinatto Marcella Ferraz, de Azevedo Fábio Mícolis
Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, São Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil.
Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, São Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil; La Trobe Sports and Exercise Medicine Research Centre (LASEM), School of Allied Health, La Trobe University, Bundoora, Victoria, Australia.
Gait Posture. 2018 May;62:366-371. doi: 10.1016/j.gaitpost.2018.03.037. Epub 2018 Mar 26.
Patellofemoral pain (PFP) has been linked to increased patellofemoral joint stress as a result of excessive hip internal rotation. Lower hip strength and/or excessive rearfoot eversion have been used to explain such altered movement pattern; however, it is unknown which one is the best predictor of excessive hip internal rotation.
To investigate if peak rearfoot eversion and/or peak concentric hip abductor strength can predict peak hip internal rotation during stair ascent in women with PFP.
This cross-sectional study included thirty-seven women with PFP which underwent three-dimensional kinematic analysis during stair ascent and hip abductor strength analysis in an isokinetic dynamometer. A forced entry linear regression model analysis was carried out to determine which independent variables present the best capability to predict the hip internal rotation.
Peak concentric hip abductor strength significantly predicted peak hip internal rotation during stair ascent (R = 0.27, p = 0.001). Peak rearfoot eversion did not predict peak hip internal rotation during stair ascent (R < 0.01, p = 0.62). A Post-hoc analysis was conducted to explore if a subgroup with excessive rearfoot eversion would predict hip internal rotation. Based on a previous reported cut-off point, 48.6% of the participants were classified as excessive rearfoot eversion. For the subgroup with excessive rearfoot eversion, peak concentric hip abductor strength and peak rearfoot eversion significantly predicted peak hip internal rotation during stair ascent (R = 0.26, p = 0.02; R = 0.42, p = 0.003, respectively). For non-excessive rearfoot eversion subgroup, peak concentric hip abductor strength significantly predicted peak hip internal rotation during stair ascent (R = 0.53; p < 0.001); and peak rearfoot eversion did not (R = 0.01; p = 0.65).
Findings indicate that hip muscle strength seems to be related with hip internal rotation in all women with PFP. Rearfoot eversion seems to be related with hip internal rotation only in a subgroup with excessive rearfoot eversion.
髌股疼痛（PFP）与由于髋关节过度内旋导致的髌股关节应力增加有关。髋关节力量减弱和/或后足过度外翻被用来解释这种改变的运动模式；然而，尚不清楚哪一个是髋关节过度内旋的最佳预测指标。
调查在患有PFP的女性上楼梯过程中，后足外翻峰值和/或髋关节外展肌向心收缩力量峰值是否能够预测髋关节内旋峰值。
这项横断面研究纳入了37名患有PFP的女性，她们在上楼梯过程中接受了三维运动学分析，并在等速测力计上进行了髋关节外展肌力量分析。进行了强制进入线性回归模型分析，以确定哪些自变量具有预测髋关节内旋的最佳能力。
髋关节外展肌向心收缩力量峰值显著预测了上楼梯过程中的髋关节内旋峰值（R = 0.27，p = 0.001）。后足外翻峰值并未预测上楼梯过程中的髋关节内旋峰值（R < 0.01，p = 0.62）。进行了事后分析，以探讨后足过度外翻亚组是否能预测髋关节内旋。根据先前报道的切点，48.6%的参与者被归类为后足过度外翻。对于后足过度外翻亚组，髋关节外展肌向心收缩力量峰值和后足外翻峰值显著预测了上楼梯过程中的髋关节内旋峰值（分别为R = 0.26，p = 0.02；R = 0.42，p = 0.003）。对于非后足过度外翻亚组，髋关节外展肌向心收缩力量峰值显著预测了上楼梯过程中的髋关节内旋峰值（R = 0.53；p < 0.001）；而后足外翻峰值则不能（R = 0.01；p = 0.65）。
研究结果表明，在所有患有PFP的女性中，髋部肌肉力量似乎与髋关节内旋有关。后足外翻似乎仅在一个后足过度外翻亚组中与髋关节内旋有关。
