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  • Title: Effects of three gait retraining techniques in runners with patellofemoral pain.
    Author: Dos Santos AF, Nakagawa TH, Lessi GC, Luz BC, Matsuo HTM, Nakashima GY, Maciel CD, Serrão FV.
    Journal: Phys Ther Sport; 2019 Mar; 36():92-100. PubMed ID: 30703643.
    Abstract:
    OBJECTIVES: Analyze the effects of 3 gait retraining: forefoot landing (FFOOT), 10% step rate increase (SR10%) and forward trunk lean (FTL) on lower limb biomechanics and clinical measurements in patellofemoral pain (PFP) runners. DESIGN: Case series report. SETTINGS: Biomechanical laboratory and treadmill running. PARTICIPANTS: Eighteen recreational PFP runners randomized in 3 groups. MAIN OUTCOME MEASURES: Lower limb kinematics and muscle activation were assessed at baseline and 2-week post-training. Pain intensity and function limitation, measured by AKPS (Anterior Knee Pain Scale) and LEFS (Lower Extremity Functional Scale) assessed at baseline, post-training and 6-month follow-up. Repeated measures analysis of variance was used to compare the effects of gait retraining. RESULTS: FFOOT and FTL increased the AKPS score at post-training(P = .001; P = .008) and 6-month follow-up(P < .001; P < .001). SR10% increased the AKPS score from baseline to 6-month follow-up(P = .006). Pain and LEFS score were improved after gait retraining regardless group. FFOOT presented greater gastrocnemius(P = .037) and rectus femoris pre-activation(P = .006) at post-retraining session. Gait retraining reduced the muscle activity during stance phase and increased during the late-swing regardless group. CONCLUSION: The three techniques presented clinical benefits, improvement of pain symptoms and functional scores, was not accompanied with significant biomechanics differences that could entirely explain this clinical improvement after the intervention.
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