Effects of three gait retraining techniques in runners with patellofemoral pain.


Physical Therapy Department, Federal University of São Carlos, São Carlos, Brazil. Electronic address: [Email]


OBJECTIVE : Analyze the effects of 3 gait retraining: forefoot landing (FFOOT), 10% step rate increase (SR10%) and forward trunk lean (FTL) on lower limb biomechanics and clinical measurements in patellofemoral pain (PFP) runners.
METHODS : Case series report.
METHODS : Biomechanical laboratory and treadmill running.
METHODS : Eighteen recreational PFP runners randomized in 3 groups.
METHODS : Lower limb kinematics and muscle activation were assessed at baseline and 2-week post-training. Pain intensity and function limitation, measured by AKPS (Anterior Knee Pain Scale) and LEFS (Lower Extremity Functional Scale) assessed at baseline, post-training and 6-month follow-up. Repeated measures analysis of variance was used to compare the effects of gait retraining.
RESULTS : FFOOT and FTL increased the AKPS score at post-training(P = .001; P = .008) and 6-month follow-up(P < .001; P < .001). SR10% increased the AKPS score from baseline to 6-month follow-up(P = .006). Pain and LEFS score were improved after gait retraining regardless group. FFOOT presented greater gastrocnemius(P = .037) and rectus femoris pre-activation(P = .006) at post-retraining session. Gait retraining reduced the muscle activity during stance phase and increased during the late-swing regardless group.
CONCLUSIONS : The three techniques presented clinical benefits, improvement of pain symptoms and functional scores, was not accompanied with significant biomechanics differences that could entirely explain this clinical improvement after the intervention.