Movement pattern analysis

The presentation of altered movement pattern is common in patients with patellofemoral pain as well as its association with self-reported pain and poor function capacity. Therapists should carefully assess the movement patterns throughout the kinetic chain during different tasks, as identified biomechanical deficits may indicate a more severe condition and can help guide an individual specific treatment plan.

Functional performance measures that simulate daily activities, are often explored to objectively measure altered movement pattern in patients with patellofemoral pain, some clinical tests have been proposed to facilitate such analysis. In this section, you will find some alternatives to assess movement pattern in the clinical setting.

Identification of altered movement pattern of a patient with patellofemoral pain might aid in the therapist’ selection of appropriate rehabilitation, which may include movement retraining. The current “gold-standard” for analysing movement pattern is three-dimensional (3D) motion analysis. However, the cost and expertise required to obtain accurate and reliable data with 3D motion analysis makes it less feasible for use in the clinical setting. Possible alternatives for the clinical setting include: two-dimensional (2D) motion analysis using video camera and/or visual observation.

Some altered movement patterns during running have been reported as a risk factor to the development of patellofemoral pain (e.g. excessive hip adduction, knee valgus) and can be screened by video analysis.

Important note: The addition of markers on the center of patella and ASIS may help identify altered movement pattern.

The forward step down test is a reliable functional test that simulates, in the clinical environment, the activity of going down stairs, increasing the load on the knee at different flexion angles, as well as dynamic muscle control. Participants should stand on a platform or a step in a bipodal stance and step forward to tap with their non-test leg on the ground in front of the step, while keeping the tested leg on the step, before returning to starting position.

 

See the video below for further details on how to perform and score the forward step down test.

The single-leg squat test is a clinical test often used in patient assessment to determine hip muscle function.

How to perform:

Patients should fold their arms across their chest and squat down as far as possible 5 times consecutively, in a slow, controlled manner, maintaining their balance, at a rate of approximately 1 squat per 2 seconds. During the single-leg squat trials, the patients should be captured on digital video, with the video camera placed approximately 3m in front of the patient on a tripod at the height of the patient’s pelvis.

How to score:

The descriptions of the requirements to be considered ‘‘good’’ for every component of each criterion are listed in the figure on the rigt.
– To be considered good, the patient need to achieve all requirements for 4 out of 5 criteria for all of the 5 trials.
– The performance is considered poor if the patient do not meet all of the requirements for at least 1 criterion for all of the trials.
– Those patients who cannot be rated as good or poor should be rated as fair.

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