Effect of ankle dorsiflexion range of motion on knee biomechanics: implications for patellofemoral pain syndrome

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Elena Suzanne Schacht (Creator)
Institution
The University of North Carolina at Greensboro (UNCG )
Web Site: http://library.uncg.edu/
Advisor
Sandra Shultz

Abstract: Patellofemoral pain syndrome (PFPS), or pain in the area of the kneecap, has been diagnosed in as many as one in four patients seen at a sports medicine clinic, yet its etiology and risk factors are surprisingly not well understood (Devereaux & Lachmann, 1984). Lack of consensus in the literature suggests that the cause of PFPS is multifactorial, and in fact the etiology may be dependent on individual patients. One of the commonly studied risk factors for developing patellofemoral pain syndrome is overpronation at the subtalar joint. Patients with PFPS have been observed to have less dorsiflexion range of motion as compared to healthy individuals, though the topic has not been thoroughly investigated (Piva, Goodnite, & Childs, 2005; Witrouw, Lysens, & Bellemans, 2000). Compensatory pronation due to tightness of the plantar flexors may translate proximally into movement at the knee as the body continues to absorb the shock of landing, especially during running. Therefore, the purpose of this study was to examine how dorsiflexion range of motion (DFROM) is related to movement at the knee in the transverse, sagittal, and frontal planes. DFROM was measured during a weight-bearing lunge. Initial, peak, and excursion values for the ankle, knee and hip was calculated during the initial phase of a drop jump landing, as well as maximum joint moments, stiffness, and energy absorption for extensors of the lower extremity. Pearson product-moment correlations determined relationships between DFROM and ankle, knee, and hip kinetics and kinematics. Results showed positive correlations between dorsiflexion range of motion and peak ankle and knee flexion (Ankle: r = .637, p = .003; Knee: r = .604, p =.006), as well as knee flexion and hip flexion excursion (Knee: r = .634, p=.004; Hip: r = .461, p = .047) No significant correlations were seen in any other planes. No correlations were seen with joint moments or stiffness values, but there was a significant correlation between DFROM and knee and hip energy absorption (Knee: r = -.456, p = .049; Hip: r = -.524 p = .021). These results support the idea that ankle dorsiflexion range of motion is related to proximal biomechanics, however the effects are limited to the sagittal plane. Those with lower values of dorsiflexion range of motion appear to have a propensity toward a "harsher" landing, which may increase their risk for sustaining both overuse and acute injuries.

Additional Information

Publication
Dissertation
Language: English
Date: 2014
Keywords
Ankle dorsiflexion, Knee biomechanics
Subjects
Knee $x Mechanical properties
Ankle $x Mechanical properties
Patellofemoral joint $x Wounds and injuries

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