Effects of altering walking foot strike pattern in combination with lower extremity strengthening on lower limb alignment in females with patellofemoral pain: a randomized controlled trial.

BACKGROUND

Rear-foot eversion increases the patellofemoral joint stress through the mechanism of lower extremity coupling. Therefore, the present clinical trial aimed to evaluate the effects of altering walking foot strike pattern in combination with lower extremity strengthening on lower limb alignment in females with patellofemoral pain (PFP).

METHODS

Forty women with PFP were randomly assigned to experimental (n = 20) and control groups (n = 20). For 8 weeks, the experimental group received the forefoot strike pattern combined with foot-knee strengthening exercises. Versus, the control group during 8 weeks did not receive any intervention aimed at treating PFP. The primary outcome was self-reported pain. The secondary outcome was rear-foot eversion, dynamic knee valgus (DKV), pelvic drop, hip extensor, hip abductor, and knee extensor muscle strength, which were measured before and after 8 weeks. Covariance analysis was used to compare the results between the two groups.

RESULTS

A significant difference was observed in reduced pain (P < 0.001, η = 0.884), rear-foot eversion (P < 0.001, η = 0.880), DKV (P < 0.001, η = 0.740), and pelvic drop (P < 0.001, η = 0.540). In addition, a significant difference was observed in the increase in the muscle strength of the hip extensor (P < 0.001, η = 0.743), hip abductor (P < 0.001, η = 0.770), and knee extensor (P < 0.001, η = 0.811).

CONCLUSION

Eight weeks the lower limb strengthening and changes in foot strike during walking can have clinical importance in reducing self-reported pain, rear-foot eversion, DKV, and pelvic drop during a single leg squat.