Showing papers by "Christian J Barton published in 2011"
TL;DR: There are differences in lower limb biomechanics between those with and without Achilles tendinopathy that may have implications for the prevention and management of the condition.
Abstract: Abnormal lower limb biomechanics is speculated to be a risk factor for Achilles tendinopathy. This study systematically reviewed the existing literature to identify, critique and summarise lower limb biomechanical factors associated with Achilles tendinopathy. We searched electronic bibliographic databases (Medline, EMBASE, Current contents, CINAHL and SPORTDiscus) in November 2010. All prospective cohort and case-control studies that evaluated biomechanical factors (temporospatial parameters, lower limb kinematics, dynamic plantar pressures, kinetics [ground reaction forces and joint moments] and muscle activity) associated with mid-portion Achilles tendinopathy were included. Quality of included studies was evaluated using the Quality Index. The magnitude of differences (effect sizes) between cases and controls was calculated using Cohen's d (with 95% CIs). Nine studies were identified; two were prospective and the remaining seven case-control study designs. The quality of 9 identified studies was varied, with Quality Index scores ranging from 4 to 15 out of 17. All studies analysed running biomechanics. Cases displayed increased eversion range of motion of the rearfoot (d = 0.92 and 0.67 in two studies), reduced maximum lower leg abduction (d = -1.16), reduced ankle joint dorsiflexion velocity (d = -0.62) and reduced knee flexion during gait (d = -0.90). Cases also demonstrated a number of differences in dynamic plantar pressures (primarily the distribution of the centre of force), ground reaction forces (large effects for timing variables) and also showed reduced peak tibial external rotation moment (d = -1.29). Cases also displayed differences in the timing and amplitude of a number of lower limb muscles but many differences were equivocal. There are differences in lower limb biomechanics between those with and without Achilles tendinopathy that may have implications for the prevention and management of the condition. However, the findings need to be interpreted with caution due to the limited quality of a number of the included studies. Future well-designed prospective studies are required to confirm these findings.
97 citations
TL;DR: Reduced peak hip internal rotation and gait velocity in individuals with PFPS may indicate compensation to reduce PFJ load during walking, and earlier peak rearfoot eversion may be a factor related to the pathomechanical development of the condition.
74 citations
TL;DR: The fair association between pronated foot posture as indicated by the FPI and earlier peak rearfoot eversion relative to the laboratory observed exclusively in those with PFPS is consistent with the biomechanical model of PFPS development.
Abstract: Background
Foot posture assessment is commonly undertaken in clinical practice for the evaluation of individuals with patellofemoral pain syndrome (PFPS), particularly when considering prescription of foot orthoses. However, the validity of static assessment to provide insight into dynamic function in individuals with PFPS is unclear. This study was designed to evaluate the extent to which a static foot posture measurement tool (the Foot Posture Index - FPI) can provide insight into kinematic variables associated with foot pronation during level walking in individuals with PFPS and asymptomatic controls.
74 citations
TL;DR: Foot orthoses may be most effective in the subgroup of people with PFPS and increased dynamic foot pronation, and a greater peak rearfoot eversion is predictive of marked improvement 12 weeks following prefabricated foot orthoses prescription in individuals withPFPS.
Abstract: Objective There is growing evidence for the provision of foot orthoses when treating individuals with patellofemoral pain syndrome (PFPS), and prescription is frequently based on the assessment of foot posture/function. However, evaluation of the link between abnormal foot posture/function and foot orthoses outcomes has previously been limited to static alignment measures and has produced inconsistent findings. In this study, the ability of baseline foot kinematics associated with pronation to predict marked improvement 12 weeks following foot orthoses prescription in individuals with PFPS was evaluated. Methods 26 individuals with PFPS were issued with prefabricated foot orthoses, and patient-reported level of improvement was documented at 12 weeks. Potential predictors of marked improvement at 12 weeks were measured during walking at baseline and included forefoot dorsiflexion and abduction, and rearfoot eversion. Results Of the 25 participants who completed the study, seven (28%) reported marked improvement with the foot orthoses after 12 weeks. Discriminant function analysis revealed a greater peak rearfoot eversion to be the only significant independent predictor of marked improvement. Conclusion These findings provide preliminary evidence that greater peak rearfoot eversion is predictive of marked improvement 12 weeks following prefabricated foot orthoses prescription in individuals with PFPS. Therefore, foot orthoses may be most effective in the subgroup of people with PFPS and increased dynamic foot pronation.
57 citations
TL;DR: A more pronated foot type and poorer footwear motion control properties were found to be associated with reduced pain during the single-leg squat and improvements in the number of pain-free single- leg rises from sitting when wearing foot orthoses.
Abstract: Objective Patellofemoral pain syndrome (PFPS) often results in reduced functional performance. There is growing evidence for the use of foot orthoses to treat this multifactorial condition. In this study, the immediate effects of foot orthoses on functional performance and the association of foot posture and footwear with improvements in function were evaluated. Methods Fifty-two individuals with PFPS (18–35 years) were prescribed prefabricated foot orthoses (Vasyli Pro; Vasyli International, Labrador, Australia). Functional outcome measures evaluated included the change in (1) pain and (2) ease of a single-leg squat on a five-point Likert scale, and change in the number of (3) pain-free step downs and (4) single-leg rises from sitting. The association of foot posture using the Foot Posture Index, navicular drop and calcaneal angle relative to subtalar joint neutral; and the footwear motion control properties scale score with improved function were evaluated using Spearman9s ρ statistics. Results Prefabricated foot orthoses produced significant improvements (p Conclusion Prefabricated foot orthoses provide immediate improvements in functional performance, and these improvements are associated with a more pronated foot type and poorer footwear motion control properties. Keywords foot orthoses; patellofemoral pain syndrome; functional performance; knee pain; insoles.
43 citations
TL;DR: Functional performance improvements following unmodified prefabricated foot orthoses were greater at 12 weeks that those achieved immediately and enhanced functional performance over time may have significant implications for osteoarthritis prevention in some individuals with PFPS.
38 citations
TL;DR: Individuals with PFPS who wear less supportive footwear, report lower levels of pain, exhibit less ankle dorsiflexion range of motion, and report an immediate reduction in pain with foot orthoses when performing a single-leg squat are more likely to benefit from foot Orthoses.
Abstract: Purpose: There is emerging evidence that foot orthoses are effective in the management of patellofemoral pain syndrome (PFPS). However, the identification of those most likely to benefit from foot orthoses has not been adequately explored. The aim of this study was to develop a preliminary clinical prediction rule to help identify individuals with PFPS who are most likely to benefit from foot orthoses.
Methods: A total of 60 individuals with PFPS were issued with noncustomized prefabricated foot orthoses containing built-in arch supports and 4° rear foot varus wedging. Patient-reported level of improvement was documented at 12 wk. Potential baseline predictor variables of interest included patient demographics, pain characteristics, footwear motion control properties, foot and ankle characteristics, and functional performance measures.
Results: Fourteen (25%) participants reported marked improvement at 12 wk. The number of participants with marked improvement increased to 78% if three of the following four criteria were met: footwear motion control properties score of <5.0 (indicative of less supportive footwear), usual pain <22.0 mm, ankle dorsiflexion range of motion (knee flexed) <41°, and reduced single-leg squat pain when wearing the orthoses.
Conclusions: Individuals with PFPS who wear less supportive footwear, report lower levels of pain, exhibit less ankle dorsiflexion range of motion, and report an immediate reduction in pain with foot orthoses when performing a single-leg squat are more likely to benefit from foot orthoses.
36 citations
TL;DR: A clinical prediction rule is developed to help identify individuals with PFPS who are most likely to benefit from foot orthoses and whether kinematic measures of lower limb function are associated with foot Orthoses efficacy.
Abstract: Background There is emerging evidence that foot orthoses are effective in the management of patellofemoral pain syndrome (PFPS), however the identification of those most likely to benefit from orthoses has not been adequately explored. The primary aim of this study was to develop a clinical prediction rule to help identify individuals with PFPS who are most likely to benefit from foot orthoses. The secondary aim was to determine whether kinematic measures of lower limb function are associated with foot orthoses efficacy.
3 citations
TL;DR: Patellar taping provides an effective means of pain relief in PFPS in the immediate term and further high quality randomised trials with long term follow-up evaluating the efficacy of patella taping as an adjunct or alternative treatment to other evidence based interventions is needed.
Abstract: Pain reduction through patella taping has been hypothesised to be achieved via changes to neuromuscular control and/or patellofemoral joint (PFJ) kinematics. Considering the high number of recent publications, a systematic review and meta-analysis evaluating the effects of patellar taping on pain, neuromuscular control and PFJ kinematics is warranted. MEDLINE, CINAHL, SPORTDiscus, Google Scholar, Web of Science, and EMBASE databases were searched from inception until February 2011 for randomised studies evaluating the effects of patellar taping on pain, neuromuscular control, and/or PFJ kinematics in individuals with PFPS. All potential publications were assessed by 2 independent reviewers for inclusion and quality using the Downs and Black Quality Index. Ten studies were included for final review. Two studies investigated medium to longer term effects of taping on pain (4 to 52 weeks), and eight studies investigated the immediate effects of taping on pain, neuromuscular control, and/or PFJ kinematics. Effect size calculations showed that perceived pain was reduced at four weeks by medially directed taping in combination with exercise. In the immediate term, medially directed patellar taping reduced pain during functional tasks. Patellar taping was found to reduce vastus medialis (VMO) to vastus lateralis (VL) ratio, and produce earlier vastus medialis oblique (VMO) activation. Patellar taping provides an effective means of pain relief in PFPS in the immediate term. Additionally, further high quality randomised trials with long term follow-up evaluating the efficacy of patellar taping as an adjunct or alternative treatment to other evidence based interventions is needed. Possible neuromuscular mechanisms behind patellar taping efficacy may be reduced levels and earlier onsets of VMO activity. There is a paucity of research evaluating the effects of patellar taping on PFJ kinematics.
3 citations
TL;DR: The aim of this study was to compare forefoot, rearfoot and tibial kinematics associated with foot pronation between individuals with PFPS and controls.
Abstract: Background Excessive foot pronation during gait is frequently linked to patellofemoral pain syndrome (PFPS) development, due a proposed coupling of increased foot pronation with increased tibial and femoral internal rotation. However, there is a paucity of research which has compared kinematics associated with foot pronation between individuals with PFPS and controls. The aim of this study was to compare forefoot, rearfoot and tibial kinematics associated with foot pronation between individuals with PFPS and controls.
3 citations
TL;DR: Tri-planar motion of the tibia, rearfoot and forefoot during barefoot walking were recorded from 10 cameras and evaluated using a three-dimensional motion analysis system incorporating a multi-segment foot model (OFM).
Abstract: Methods Nineteen participants with normaland flat-arched feet were recruited for this study (10 with normal and 9 with flat-arched feet). A foot screening protocol comprising measurements from weightbearing antero-posterior and lateral foot radiographs were used to classify foot posture. Tri-planar motion of the tibia, rearfoot and forefoot during barefoot walking were recorded from 10 cameras and evaluated using a three-dimensional motion analysis system incorporating a multi-segment foot model (OFM).
TL;DR: Three-dimensional EMG maps based on quadriceps muscle amplitude, muscle onset, and lower-limb kinematics in participants with and without patellofemoral pain (PFP) during functional activity are created using a 2×2 factorial design.
Abstract: Patellofemoral pain syndrome (PFPS) arises from patellofemoral articulation, caused in part by inefficient quadriceps muscle activity. Many studies have used surface electromyography (sEMG) to investigate quadriceps activity, with conflicting results. This study is novel in the use of 64-channel surface EMG combined with motion capture. The aim was to create three-dimensional (3-D) EMG maps based on quadriceps muscle amplitude, muscle onset, and lower-limb kinematics in participants with and without patellofemoral pain (PFP) during functional activity using a 2×2 factorial design. Two participants with PFP and three asymptomatic controls were recruited. 64-channel EMG onset and amplitude from the vastus lateralis (VL), rectus femoris (RF), and vastus medialis oblique (VMO) muscles, and motion-analysis data were collected simultaneously during functional activity. Correlation coefficients (CCs) were calculated for within subject and between subject groups. CCs identified significant patterns of activity within subject groups (P