Dataset Information

Altering Knee Abduction Angular Impulse Using Wedged Insoles for Treatment of Patellofemoral Pain in Runners: A Six-Week Randomized Controlled Trial.

ABSTRACT:

Objective

Determine if a change in internal knee abduction angular impulse (KAAI) is related to pain reduction for runners with patellofemoral pain (PFP) by comparing lateral and medial wedge insole interventions, and increased KAAI and decreased KAAI groups.

Design

Randomized controlled clinical trial (ClinicalTrials.gov ID# NCT01332110).

Setting

Biomechanics laboratory and community.

Patients

Thirty-six runners with physician-diagnosed PFP enrolled in the trial, and 27 were analyzed.

Interventions

Runners with PFP were randomly assigned to either an experimental 3 mm lateral wedge or control 6 mm medial wedge group. Participants completed a biomechanical gait analysis to quantify KAAIs with their assigned insole, and then used their assigned insole for six-weeks during their regular runs. Usual pain during running was measured at baseline and at six-week follow-up using a visual analog scale. Statistical tests were performed to identify differences between wedge types, differences between biomechanical response types (i.e. increase or decrease KAAI), as well as predictors of pain reduction.

Main outcome measures

Percent change in KAAI relative to neutral, and % change in pain over six weeks.

Results

Clinically meaningful reductions in pain (>33%) were measured for both footwear groups; however, no significant differences between footwear groups were found (p = 0.697). When participants were regrouped based on KAAI change (i.e., increase or decrease), again, no significant differences in pain reduction were noted (p = 0.146). Interestingly, when evaluating absolute change in KAAI, a significant relationship between absolute % change in KAAI and % pain reduction was observed (R2 = 0.21; p = 0.030), after adjusting for baseline pain levels.

Conclusion

The greater the absolute % change in KAAI during running, the greater the % reduction in pain over six weeks, regardless of wedge type, and whether KAAIs increased or decreased. Lateral and medial wedge insoles were similar in effectiveness for treatment of PFP.

Clinical relevance

Altering KAAI should be a focus of future PFP research. Lateral wedges should be studied further as an alternative therapy to medial wedges for management of PFP.

Trial registration

ClinicalTrials.gov NCT01332110.

SUBMITTER: Lewinson RT

PROVIDER: S-EPMC4521888 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Altering Knee Abduction Angular Impulse Using Wedged Insoles for Treatment of Patellofemoral Pain in Runners: A Six-Week Randomized Controlled Trial.

Lewinson Ryan T RT Wiley J Preston JP Humble R Neil RN Worobets Jay T JT Stefanyshyn Darren J DJ

PloS one 20150731 7

<h4>Objective</h4>Determine if a change in internal knee abduction angular impulse (KAAI) is related to pain reduction for runners with patellofemoral pain (PFP) by comparing lateral and medial wedge insole interventions, and increased KAAI and decreased KAAI groups.<h4>Design</h4>Randomized controlled clinical trial (ClinicalTrials.gov ID# NCT01332110).<h4>Setting</h4>Biomechanics laboratory and community.<h4>Patients</h4>Thirty-six runners with physician-diagnosed PFP enrolled in the trial, an ...[more]

PMID: 26230399

Similar Datasets

Project description:BackgroundAltered kinematics have been frequently observed in runners with patellofemoral pain (PFP), and few studies have aimed to understand the influence of sex on kinematics of this population. The aim of this study was to investigate whether altered hip and knee kinematics in runners with PFP are sex specific.HypothesisKinematics will be different between female and male runners with and without PFP.Study designCase-control study.Level of evidenceLevel 2.MethodsEighty-four runners were divided into 4 groups: 42 runners with PFP (20 women, 22 men) and 42 asymptomatic runners (21 women, 21 men). Three-dimensional gait analyses of the hip in the frontal and transverse plane and the knee in the frontal plane were analyzed at self-selected running speed on a treadmill. One-way analysis of covariance was used to test for differences in kinematic variables between groups.ResultsWomen with PFP ran with a significantly greater peak hip adduction compared with men with PFP (mean difference [MD] = 4.45°; P = 0.00; effect size [ES] = 0.58) and male control subjects (MD = 4.2°; P = 0.01; ES = 0.54) and greater hip adduction range of motion (ROM) than men with PFP (MD = 3.44°; P = 0.01; ES = 0.49). No significant differences were identified between women with and without PFP. Female control subjects ran with greater peak hip adduction than men with PFP (MD = 5.46°; P < 0.01; ES = 0.58) and male control subjects (MD = 5.21°; P < 0.01; ES = 0.55); greater hip adduction ROM than men with PFP (MD = 4.02°; P = 0.00; ES = 0.52) and male control subjects (MD = 2.91°;P = 0.04; ES = 0.36); and greater peak knee abduction than men with PFP (MD = 3.35°; P = 0.02; ES = 0.44) and male control subjects (MD = 3.69°; P = 0.01; ES = 0.4).ConclusionWomen have greater hip adduction than men regardless of the presence of PFP. There were no kinematics difference between women with and without PFP. Comparisons of hip internal rotation between all groups were nonsignificant.Clinical relevanceAltered hip and knee kinematics does not appear to be sex specific in runners with PFP.

Project description:BackgroundIn this randomized clinical trial, we aimed to determine whether increasing the frequency of in-center hemodialysis would result in beneficial changes in left ventricular mass, self-reported physical health, and other intermediate outcomes among patients undergoing maintenance hemodialysis.MethodsPatients were randomly assigned to undergo hemodialysis six times per week (frequent hemodialysis, 125 patients) or three times per week (conventional hemodialysis, 120 patients) for 12 months. The two coprimary composite outcomes were death or change (from baseline to 12 months) in left ventricular mass, as assessed by cardiac magnetic resonance imaging, and death or change in the physical-health composite score of the RAND 36-item health survey. Secondary outcomes included cognitive performance; self-reported depression; laboratory markers of nutrition, mineral metabolism, and anemia; blood pressure; and rates of hospitalization and of interventions related to vascular access.ResultsPatients in the frequent-hemodialysis group averaged 5.2 sessions per week; the weekly standard Kt/V(urea) (the product of the urea clearance and the duration of the dialysis session normalized to the volume of distribution of urea) was significantly higher in the frequent-hemodialysis group than in the conventional-hemodialysis group (3.54±0.56 vs. 2.49±0.27). Frequent hemodialysis was associated with significant benefits with respect to both coprimary composite outcomes (hazard ratio for death or increase in left ventricular mass, 0.61; 95% confidence interval [CI], 0.46 to 0.82; hazard ratio for death or a decrease in the physical-health composite score, 0.70; 95% CI, 0.53 to 0.92). Patients randomly assigned to frequent hemodialysis were more likely to undergo interventions related to vascular access than were patients assigned to conventional hemodialysis (hazard ratio, 1.71; 95% CI, 1.08 to 2.73). Frequent hemodialysis was associated with improved control of hypertension and hyperphosphatemia. There were no significant effects of frequent hemodialysis on cognitive performance, self-reported depression, serum albumin concentration, or use of erythropoiesis-stimulating agents.ConclusionsFrequent hemodialysis, as compared with conventional hemodialysis, was associated with favorable results with respect to the composite outcomes of death or change in left ventricular mass and death or change in a physical-health composite score but prompted more frequent interventions related to vascular access. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; ClinicalTrials.gov number, NCT00264758.).

Project description:ContextConsidering current models that highlight the role of psychological components in pain management, mindfulness practice may be an effective strategy in the management of pain.ObjectiveTo examine the effects of adding an 8-week mindfulness program to exercise therapy on the perceptions of pain severity, knee function, fear of movement, and pain catastrophizing of female recreational runners with patellofemoral pain (PFP).DesignRandomized controlled clinical trial.SettingUniversity laboratory.Patients or other participantsThirty female runners (age = 28.3 ± 7.08 years) with PFP were randomly assigned to the exercise or mindfulness-exercise group.Intervention(s)The exercise-only group followed a protocol (18 weeks, 3 sessions/wk) that featured training modifications to help control injury-related symptoms. The mindfulness-exercise group received an 8-week mindfulness intervention in addition to the exercise protocol. The mindfulness component started 4 weeks before the exercise component; therefore, the 2 components overlapped during the first 4 weeks of the intervention.Main outcome measure(s)Usual pain, pain during stepping, and pain during running were assessed using visual analog scales. Functional limitations of the knee were assessed using the Knee Outcome Survey. Fear of movement, pain catastrophizing, and coping strategies were measured via the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, and the Coping Strategies Questionnaire, respectively. These outcomes were assessed at baseline, at week 9, and after 18 weeks.ResultsPain during running, pain during stepping, and functional limitations of the knee were less for the mindfulness-exercise group than for the exercise-only group (P values < .05). The mindfulness-exercise group reported greater perceived treatment effects than the exercise-only group (P < .05). Pain catastrophizing was less and coping strategies were more favorable for mindfulness-exercise participants than for exercise-only participants (P values < .05).ConclusionsMindfulness practice can be an effective adjunct to exercise therapy in the rehabilitation of PFP in recreational female runners.

Dataset Information

Altering Knee Abduction Angular Impulse Using Wedged Insoles for Treatment of Patellofemoral Pain in Runners: A Six-Week Randomized Controlled Trial.

Objective

Design

Setting

Patients

Interventions

Main outcome measures

Results

Conclusion

Clinical relevance

Trial registration

Publications

Altering Knee Abduction Angular Impulse Using Wedged Insoles for Treatment of Patellofemoral Pain in Runners: A Six-Week Randomized Controlled Trial.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets