Frontal plane projection angle predicts patellofemoral pain: Prospective study in male military cadets.

BACKGROUND: Patellofemoral pain (PFP) is a major source of knee pain. Identifying who may develop PFP is of paramount importance. PURPOSE: To assess whether Frontal plane projection angles (FPPA) and hand held dynamometry (HHD) strength measures can predict development of PFP. STUDY DESIGN: Prospective evaluation of individuals undertaking a military training programme. METHODS: Male military recruits were enrolled and prospectively followed up from enrolment to completion of 12-weeks training. Lower limb kinematics (FPPA, Q-angle, hip adduction angle, knee flexion, ankle dorsiflexion, and rearfoot eversion angle) measured during running, single leg squatting (SLS), and single leg landing (SLL) and isometric muscle strength of hip abductors and knee extensors. RESULTS: Body mass, hip abductor muscle strength, Q-angle during SLS and SLL, FPPA during SLL all significantly different between the PFP and non-injured groups and predicted PFP, highest predictor variable was FPPA during SLL (Odds Ratio = 1.13, P = 0.01). A FPPA≥5.2° during SLL predicting PFP with a sensitivity of 70% and a specificity of 70%. CONCLUSION: Participants who developed PFP had a number of physical factors significantly different than the non-injured group, most predictive was a larger FPPA during SLL, with angles greater than 5.2° associated with a 2.2x greater risk. CLINICAL RELEVANCE: Assessing FPPA during SLL could be used to determine who was predisposed to PFP.

The reliability and criterion validity of 2D video assessment of single leg squat and hop landing.

The objective was to assess the intra-tester, within and between day reliability of measurement of hip adduction (HADD) and frontal plane projection angles (FPPA) during single leg squat (SLS) and single leg landing (SLL) using 2D video and the validity of these measurements against those found during 3D motion capture. 15 healthy subjects had their SLS and SLL assessed using 3D motion capture and video analysis. Inter-tester reliability for both SLS and SLL when measuring FPPA and HADD show excellent correlations (ICC2,1 0.97-0.99). Within and between day assessment of SLS and SLL showed good to excellent correlations for both variables (ICC3,1 0.72-91). 2D FPPA measures were found to have good correlation with knee abduction angle in 3-D (r=0.79, p=0.008) during SLS, and also to knee abduction moment (r=0.65, p=0.009). 2D HADD showed very good correlation with 3D HADD during SLS (r=0.81, p=0.001), and a good correlation during SLL (r=0.62, p=0.013). All other associations were weak (r<0.4). This study suggests that 2D video kinematics have a reasonable association to what is being measured with 3D motion capture.