An investigation of the clinical relationship between foot posture and patellofemoral joint alignment

View/ open
Author
Curran, Sarah
Date
2008Type
Thesis
Publisher
Cardiff Metropolitan University
Metadata
Show full item recordAbstract
It has been suggested that abnormal foot posture is related to patellofemoral joint pain. An understanding of the relationship hinges on assessment of the relationship between the two, but whilst satisfactory (reliable and valid) clinical methods of foot posture exist, there is no consensus on the optimal technique for assessing patellofemoral joint alignment. Therefore, a series of studies were performed to examine standardisation, reliability, validity and functional significance of patellofemoral joint alignment measures (Q, modified A, tibiofemoral joint and tubercle sulcus angles). Intraclass correlation coefficients of all measures was fair-to-excellent (standard error of measurement <2o), whilst each measure showed significant differences (p<0.001) in selected foot positions and postures (i.e. 10o abduction, maximally pronated). A cross-sectional study then investigated normal values for these measures in 335 asymptomatic individuals. The Foot Posture Index© was used to categorise participants into pronated (n=110), neutral (n=111) and supinated (n=114) groups. All patellofemoral joint measures differed significantly between pronated and supinated foot postures, with values tending to increase with pronation. This data was used to categorise 60 asyrmptomatic individuals into three patellofemoral joint alignment groups (high, central and low, n=20 per group), and a group of patellofemoral joint pain patients was also included. Rearfoot and midfoot loading characteristics were obtained using the EMED® -m system. Comparisons between groups showed significant differences, with high and patellofemoral joint pain groups demonstrating slower and reduced loading at the rear and midfoot compared to central and low groups (p<0.001). Whilst further inquiry is required this data suggests that foot posture, functional foot loading characteristics and patellofemoral joint alignment are related. Differences in loading characteristics suggest a mechanism by which patellofemoral joint alignment and foot posture may be related to pathology. This provides a rationale for clinical interventions aimed at modifying foot and/or patellofemoral joint alignment.
Description
PhD
Collections
Related items
Showing items related by title, author, subject and abstract.
-
Clinical Lower Limb Alignment in Medial Knee Osteoarthritis and the role of Laterally Wedged Orthoses
Fernandes, Gwen (Cardiff Metropolitan University, 2012)Osteoarthritis (OA) often affects the medial tibiofemoral joint (TFJt) of the knee. Foot posture could explain inconclusive study findings evaluating laterally wedged orthoses (LWOs) as an intervention. The overall aim of ... -
Quantifying frontal plane knee motion during single limb squats: Reliability and validity of 2‐dimensional measures
Gwynne, Craig; Curran, Sarah (American Physical Therapy Association, 2014-12)Background: Clinical assessment of lower limb kinematics during dynamic tasks may identify individuals who demonstrate abnormal movement patterns that may lead to etiology of exacerbation of knee conditions such as ... -
Two-dimensional frontal plane projection angle can identify subgroups of patellofemoral pain patients who demonstrate dynamic knee valgus
Gwynne, Craig; Curran, Sarah (Elsevier, 2018-07-03)Background Identifying individuals with patellofemoral pain who demonstrate similar modifiable factors including dynamic knee valgus may be useful in establishing subgroups of patients that can undergo individualised ...