Gait Retraining With Real-Time Visual Feedback to Treat Patellofemoral Pain in Adult Recreational Runners: A Critically Appraised Topic.

Clinical Scenario: Patellofemoral pain (PFP) is a common knee injury in recreational adult runners, possibly caused by faulty mechanics. One possible approach to reduce this pain is to retrain the runner's gait. Current research suggests that no definitive gold standard treatment for PFP exists. Gait retraining utilizing visual feedback may reduce PFP in both the short and long term. Clinical Question: In adult runners diagnosed with PFP, does gait retraining with real-time visual feedback lead to a decrease in pain? Summary of Key Findings: A literature search was performed; 3 relevant studies utilizing gait retraining with visual feedback, pain level as an outcome measure, and follow-up measures of at least 1 month after the intervention were included. All the included studies reported a decrease in short- and long-term pain for participants following visual feedback gait retraining. In addition, biomechanical measures related to PFP, including peak hip adduction angle and the angle of contralateral pelvic drop, improved after the completion of the intervention. Clinical Bottom Line: There is level 2 evidence supporting the implementation of 8 sessions over 2 weeks of visual feedback gait retraining as a means of treating patients diagnosed with PFP. Based on current available evidence, clinicians should identify faulty mechanics of patients and implement a protocol of increasing real-time visual feedback over the first 4 sessions and decreasing visual feedback over the final 4 sessions. Strength of Recommendation: Level 2.

Genome-Wide Association Mapping of Stem Rust Resistance in Hordeum vulgare subsp. spontaneum.

Stem rust was one of the most devastating diseases of barley in North America. Through the deployment of cultivars with the resistance gene Rpg1, losses to stem rust have been minimal over the past 70 yr. However, there exist both domestic (QCCJB) and foreign (TTKSK aka isolate Ug99) pathotypes with virulence for this important gene. To identify new sources of stem rust resistance for barley, we evaluated the Wild Barley Diversity Collection (WBDC) (314 ecogeographically diverse accessions of Hordeum vulgare subsp. spontaneum) for seedling resistance to four pathotypes (TTKSK, QCCJB, MCCFC, and HKHJC) of the wheat stem rust pathogen (Puccinia graminis f. sp. tritici, Pgt) and one isolate (92-MN-90) of the rye stem rust pathogen (P. graminis f. sp. secalis, Pgs). Based on a coefficient of infection, the frequency of resistance in the WBDC was low ranging from 0.6% with HKHJC to 19.4% with 92-MN-90. None of the accessions was resistant to all five cultures of P. graminis A genome-wide association study (GWAS) was conducted to map stem rust resistance loci using 50,842 single-nucleotide polymorphic markers generated by genotype-by-sequencing and ordered using the new barley reference genome assembly. After proper accounting for genetic relatedness and structure among accessions, 45 quantitative trait loci were identified for resistance to P. graminis across all seven barley chromosomes. Three novel loci associated with resistance to TTKSK, QCCJB, MCCFC, and 92-MN-90 were identified on chromosomes 5H and 7H, and two novel loci associated with resistance to HKHJC were identified on chromosomes 1H and 3H. These novel alleles will enhance the diversity of resistance available for cultivated barley.