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Excerpt
Increased rate of loading following heel strike has been hypothesized as being contributory to knee osteoarthritis and may be the result of decreased shock absorbing knee flexion during weight acceptance. Since patients with patellofemoral pain have been reported to limit loading response knee flexion in an attempt to minimize the patellofemoral joint reaction force, these individuals may be at risk for the adverse effects of impulsive loading. The purpose of this study was to determine if subjects with patellofemoral pain demonstrate excessive lower limb loading during gait. Force plate parameters (2500 Hz) consisting of peak vertical ground reaction force and peak loading rate, lower extremity kinematics (60 Hz), and stride characteristics were recorded simultaneously in fifteen females with patellofemoral pain and 10 controls during self-selected free and fast walking velocities. Individuals in the patellofemoral pain group demonstrated a significantly slower gait velocity during the free and fast trials as well as decreased loading response knee flexion during fast walking. The average peak rate of loading for the patellofemoral pain group was significantly less than the control group during both free (p=.004) and fast walking (p=.03). Despite diminished loading response knee flexion during fast walking, subjects with patellofemoral pain did not demonstrate impulsive loading. In general, the rate of loading appeared to be minimized by adopting a slower gait velocity. These results indicate that altered knee kinematics as a result of patellofemoral pain do not place these individuals at risk for the adverse effects of impulsive loading.
