Baropodometric quantification and implications of muscle coactivation in the lower limbs caused by head movement: A prospective study.

BACKGROUND: In healthy young adults, muscle coactivation can sometimes be induced by remote voluntary contractions when the motor task is forceful, maximal, tiring, or cyclic and brief. OBJECTIVES: To show that a change in plantar pressure is an unequivocal response to backward movement of the head, and to contribute to a better understanding of physiotherapy methods that involve remote muscle activation. METHODS: Involuntary coactivation was quantified as a percentage of the anteroposterior plantar pressure distribution, using a baropodometric platform in a population of young adults. The baropodometric data were collected from a 1s recording after 30 s in the reference condition, and from 1s recordings during the first second and then during the 120th second in the test condition. The results were analyzed with Bayesian statistics (Markov chains and Monte Carlo integration techniques). RESULTS: 90 adults participated in the study (age range: 19-26; 38 males and 52 females). The forefoot plantar pressure increased in all cases, by a mean multiplicative factor (on a logit scale) of 1.12 (from 72.24% to 74.45%) when the head was aligned over the trunk. CONCLUSIONS: This 90-participant trial confirmed our initial hypothesis: a increase in forefoot plantar pressure is a systematic response to the motor task (head movement), and suggests greater recruitment of the plantar flexor muscles. A spinal reflex and/or a previously unknown form of motor overflow might be involved in this phenomenon. These results support the development of inductive physiotherapy techniques based on remote muscle activation in the treatment of musculoskeletal disorders. CLINICALSTRIAL. GOV IDENTIFIER: NCT02320097.

Lasting relief of chronic anterior knee pain in young adult after ten weekly inductive physiotherapy sessions: A case report.

BACKGROUND: Patellofemoral pain syndrome particularly impairs quality of life in young, physically active subjects. The exact etiology remains unknown, and so this syndrome is a challenging condition to treat. Some patients continue to experience pain and dysfunction after receiving one or more guidelines-compliant conservative treatments. Reducing the likelihood of patellofemoral pain syndrome is an important way of preventing the onset of debilitating anterior knee pain at all ages of life. CASE: A 24-year-old sportswoman with a 15-month history of anterior knee pain and failure of previous guidelines-compliant treatments. We treated this patient with techniques derived from the paradigm of inductive physiotherapy, in which tone disorders with a central origin may contribute to musculoskeletal disorders. One distinctive feature of inductive physiotherapy relates to the fact that the painful area is not manipulated directly. RESULTS: The effects of physiotherapy were evaluated after ten weekly sessions and then 15 months later. The changes in the visual analogue pain scale score and the Knee Lequesne Index were clinically significant. We also observed an unexpected reduction in the static varus misalignment. CONCLUSION: This case could pave the way to an innovative neurological approach to the management of patellofemoral pain syndrome in the young adult.