Male and female gluteal muscle activity and lower extremity kinematics during running

East Carolina University, Department of Physical Therapy, Greenville, NC 27858, USA
Clinical biomechanics (Bristol, Avon) (Impact Factor: 1.88). 09/2012; 27(10). DOI: 10.1016/j.clinbiomech.2012.08.008
Source: PubMed

ABSTRACT BACKGROUND: Patellofemoral pain is one of the most common lower extremity overuse injuries in runners and is significantly more common in females. This study evaluated differences in the timing and magnitude of gluteal muscle activity as well as hip and knee joint frontal and transverse plane kinematics between male and female runners in the context of this gender bias. METHODS: Twenty healthy male and 20 healthy female runners were participants. Three-dimensional lower extremity kinematics, and gluteus medius and gluteus maximus muscle activation were recorded using motion analysis and electromyography as subjects ran at 3.7m/s (+/-5%). Comparisons of hip and knee joint kinematic and gluteus muscle activation data were made using independent t-tests (α=0.05). FINDINGS: Females ran with 40% greater peak gluteus maximus activation level (P=0.028, effect size=0.79) and 53% greater average activation level (P=0.013, effect size=0.93) than males. Female runners also displayed greater hip adduction (P=.001, effect size=1.20) and knee abduction (P=0.011, effect size=0.87) angles at initial contact, greater hip adduction at peak vertical ground reaction force (P<0.001, effect size=1.31), and less knee internal rotation excursion than males (P=0.035, effect size=0.71). INTERPRETATION: Greater gluteus maximus activation levels during running may predispose females to earlier gluteus maximus fatigue, promoting altered lower extremity running kinematics thought to be associated with the etiology of patellofemoral pain. Gender differences in transverse and frontal plane hip and knee kinematics observed in this study may also contribute to the gender bias for patellofemoral pain among females.

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    ABSTRACT: Study Design Secondary explorative analysis of a randomized controlled trial comparing supervised exercise therapy to usual care in patellofemoral pain syndrome (PFPS) patients. Objective To explore which patients with PFPS are more likely to benefit from exercise therapy. Background PFPS is a common condition in which exercise therapy is effective in reducing pain and improving function. However not all patients benefit from exercise therapy. Methods The study explores patients characteristics that might interact with treatment effects of PFPS in 131 patients treated with usual care or exercise therapy. These characteristics are tested for interaction with treatment in a regression analysis. The primary outcome measures in the present study are function and pain on activity at 3-months follow-up. Results None of the tested variables had a significant interaction with treatment. A positive trend was seen for females with PFPS; they were more likely to report higher function scores with exercise therapy than with usual care compared to males with PFPS (β:12.1 95%CI;0.23-24.0, p-value:0.05). A positive trend was seen for patients with a longer duration of complaints(>6 months); they were more likely to report higher function scores and had less pain on activity after exercise therapy than with usual care compared with those with shorter duration of complaints (β:12.3 95%CI:-0.08- 24.7, p-value:0.05; β:-1.74 95%CI;-3.90-0.43, p-value:0.12, respectively). Conclusion Two factors, gender and duration of complaints, might have a predictable value for response to exercise therapy at 3-months follow-up. Due to the explorative design of the study, future research has to confirm this tendency. Level of Evidence Prognosis, level 2b. J Orthop Sports Phys Ther, Epub 27 Jan 2015. doi:10.2519/jospt.2015.5583.
    Journal of Orthopaedic and Sports Physical Therapy 01/2015; DOI:10.2519/jospt.2015.5583 · 2.38 Impact Factor
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    ABSTRACT: Recreational runners with patellofemoral pain syndrome (PFPS) have been shown to present altered movement kinematics, muscle activations, and ground reaction forces (GRF) during running as well as decreased lower limb strength. However, these variables have never been concurrently evaluated in a specific cohort. Therefore, the aim of this study was to compare lower limb control variables during running in recreational runners with and without PFPS. Lower limb control during treadmill running under typical training conditions (usual shoes, foot strike pattern, and speed) was compared between runners with (n=21) and without (n=20) PFPS using lower limb kinematics, electromyographic (EMG) recordings from representative muscles (gluteus medius/maximus, quadriceps and soleus), and vertical GRF. Isometric muscle strength was also evaluated. When comparing all runners from both groups, no between-group differences were found in variables commonly associated with PFPS such as peak hip adduction, hip internal rotation, contralateral pelvic drop, EMG of gluteal and quadriceps muscles, vertical loading rate, or lower limb strength. However, runners with PFPS showed significantly higher hip adduction at toe-off, lower excursion in hip adduction during late-stance, and longer duration of soleus activation. Sub-analyses were performed for females and for rearfoot strikers (RFS), and revealed that these subgroups accounted for most of between-group differences in hip adduction kinematics. Specifically for RFS with PFPS, lower activation of gluteus medius as well as lower GRF were observed. Our results suggest that deficits reported in runners with PFPS may vary depending on gender and on foot strike pattern. Copyright © 2015 Elsevier B.V. All rights reserved.
    Gait & Posture 03/2015; DOI:10.1016/j.gaitpost.2015.02.020 · 2.30 Impact Factor
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    ABSTRACT: Background Patients with anterior cruciate ligament (ACL) injury often exhibit reduced movement quality during functional tasks in the form of a knee-medial-to-foot position (KMFP). This movement pattern is suggested to be more common in women than in men, but the possible contributing sensorimotor factors for this altered knee position are poorly studied in these patients. The aim of this study was to evaluate the association between sensory function and medio-lateral knee position during functional tasks in men and women with ACL injury. Methods Fifty-one patients (23 women) aged 18–40 years with ACL injury were included in this cross-sectional study. Measures of sensory function were assessed by the threshold to detection of passive motion (TDPM) for knee kinesthesia and by the vibration perception threshold (VPT) for vibration sense. Movement quality was assessed by visual observation of the position of the knee relative to the foot during the following four functional tasks with different degrees of difficulty: the single-limb mini-squat, stair descending, the forward lunge, and the drop-jump. Spearman’s rank correlation coefficient was used to determine the relationship between the sensory measures and the medio-lateral knee position during the functional tasks. Differences in TDPM and/or VPT between subjects with good and poor movement quality were evaluated using the independent t-test. Separate gender analyses were performed. Results Worse TDPM was associated with a KMFP during the drop jump in men. Worse VPT at the toe and ankle was associated with a KMFP during stair descending and the forward lunge in women, but no associations were found in men. Conclusion Worse kinesthesia, measured by TDPM, might be associated with KMFP during the drop jump in men with ACL injury while worse vibration sense, measured by the VPT, at the foot and ankle might be related to KMFP in women. Further studies are needed to confirm these results.
    BMC Musculoskeletal Disorders 12/2014; 15(1). DOI:10.1186/1471-2474-15-430 · 1.90 Impact Factor