Research Report Abstracts - Gesundheit

eS292
PFPS would generate changes in the kinetic and EMG strategies
used to perform this task.
Relevance: Despite the benefit of using upward squatting
in individuals with PFPS, there have been just few studies
describing the changes and adaptations of kinetic and EMG
patterns for individuals with musculoskeletal disorders. This
study could help for new insights for evaluation and treatment
of subjects with PFPS.
Participants: Eight healthy subjects (four males 21.8 ± 0.61
and four female 24.6 ± 1.62 years old) and eight subjects with
PFPS (four males 21.7 ± 0.52 and four female 26.5 ± 2.56
years old), but without history of pain for at least 30 days,
took part in the experiment.
Methods: They were asked to perform upward squatting
with knees initially flexed at 60 ◦ (very flexed) until reaching
an upright position. Angle, velocity, and acceleration
(kinematic) were reconstructed for knee and ankle joints
using motion analysis system (Optotrak 3020). The torques
at these joints were calculated using inverse dynamics, taking
into account anthropometric and inertial characteristics
of each subject, including records from force plate data. Only
activities of major muscles were recorded. The kinetic and
EMG profiles were quantified during eight phases, including
acceleration and deceleration phases of the upward squatting.
Analysis: The Student’s t-test for independent samples was
used to determine the effect between the groups regarding
mass, height, and linear and angular displacements. In
order to evaluate the effect of the group for muscles and
kinetics (dependent) variables during the phases of the movement
(1–8), we used two-way factorial ANOVA for repeated
measures [group (NN and PFPS) × muscles (each muscle
separately)] and [group (NN and PFPS) × kinetic variable
(COP or joint torques)].
Results: Both healthy and PFPS subjects used the same
kinetic and EMG strategies to perform the upward squatting,
even though the magnitude of the muscle activities were
decreased for the latter group. Compared to the control group,
the PFPS subjects presented larger joint ankle torques and
smaller knee joint torques. However, the subjects avoided to
keep their knees very flexed at the initial position. Group differences
in the kinetic and EMG strategies can be explained
by differences in the initial position, suggesting a protective
strategy used by subjects with PFPS.
Conclusions: The major strategy of the central nervous
system to deal with PFPS is one biomechanical response
(avoiding increased pressure at the patellofemoral joint) and
not a neurophysiologic change (i.e., pattern of muscle activations).
Implications: Despite the benefit of using upward squatting
in individuals with PFPS, coaches and/or therapists should
avoid to use this exercise when the knee is required to move
above 40 ◦ flexion. This observation is important mainly during
the initial phase of the training. Further studies are needed
to verify the best strategy to increase knee flexion beyond
40 ◦ during upward squatting, but without aggravating the
symptoms of the PFPS.
Keywords: Biomechanics; Closed kinetic chain;
Patellofemoral pain syndrome
Funding acknowledgements: FAPESP/Brazil.
Ethics approval: This study was approved by the Institutional
Review Board Ethics Committee of the State
University of Campinas.
Research Report Poster Display
Number: RR-PO-305-12-Thu Thursday 23 June 13:00
RAI: Exhibit Halls2&3
IMMEDIATE EFFECTS OF TEXTURED SHOE
INSOLES ON POSTURAL STABILITY IN PEOPLE
WITH MULTIPLE SCLEROSIS
Dixon J. 1 , Gamesby H. 1 , Robinson J. 1 , Hodgson D. 1 ,
Hatton A.L. 2 , Warnett R. 3 , Rome K. 4 , Martin D. 1
1Teesside University, School of Health & Social Care,
Middlesbrough, United Kingdom, 2University of Salford,
Manchester, United Kingdom, 3James Cook University
Hospital, Department of Rehabilitation, Middlesbrough,
United Kingdom, 4AUT University, Health & Rehabilitation
Research Institute, Auckland, New Zealand
Purpose: To investigate whether wearing textured insoles can
improve postural stability in people with Multiple Sclerosis.
Relevance: People with MS often have impairments in postural
stability. Previous studies have shown footwear, including
textured insoles, may improve postural stability. No study has
investigated the effect of textured insoles on postural stability
in people with MS. This intervention could be of benefit in
self management of MS.
Participants: 46 people with MS (34 females), age mean
(SD) 49 (7) years were recruited from local clinics and user
groups. Inclusion criteria were age 18–65 with clinical diagnosis
of MS. Exclusion criteria were self-reported inability to
walk 10 meters unassisted or with one stick or crutch, recent
musculoskeletal injury, poor foot sensation, other conditions
affecting the central nervous system, inability to understand
the instructions, or current or previous use of similar insoles.
Methods: This study used a within-session repeated measures
design. Ethical approval was granted by the Northern
and Yorkshire Research Ethics Committee in the UK. Participants
gave informed consent and attended a laboratory
setting where they carried out standard tests of quiet standing
balance of 30 second duration on a Kistler force platform.
Each participant performed 3 repetitions of bipedal standing
with eyes open, and the same with eyes closed, under 3
randomised conditions: Control (a smooth insole), Texture 1
(a custom made textured insole used in previous research),
Texture 2 (a Crocs TM insole). The primary outcome measure
was centre of pressure velocity (mm s −1 ). Secondary
outcome measures were anterior–posterior and mediolateral
sway range and standard deviation (mm).