Patellofemoral pain syndrome (PFPS) is the most common injury in runners and has a significant female sex bias. Current evidence suggests that several proximal factors, including hip muscle strength, hip muscle activation, and hip kinematics during running, play a large role in the development of PFPS, particularly in females. However, the relationships between these variables are unclear. A better understanding of these relationships in both males and females could help clinicians develop targeted interventions for this syndrome. Thus, this dissertation is comprised of four studies aimed to better understand the relationships between these risk factors. The first study investigated whether there are any relationships between hip muscle strength and hip muscle activation during running. Overall, hip muscle strength and hip muscle activity during running do not appear to be strongly related. The second study used a multiple regression approach to look for predictors of hip adduction and hip internal rotation during running. Sex was a significant predictor in both models, and running speed, static subtalar inversion range of motion, and gluteus maximus amplitude were significant predictors in the hip adduction model. The third study examined the effect of decreasing hip abduction strength on running kinematics and hip muscle EMG. After the fatigue protocol, there were no changes in gluteus medius amplitude or timing, and no changes in hip kinematics during running. However, there were some changes in kinematics, particularly at the trunk, as well as differences in gluteus maximus and tensor fascia latae activation. Finally, the fourth study used an alternative biomechanical method called continuous relative phase (CRP) to investigate the effect of sex and decreasing hip abduction strength on CRP variability at the hip. Decreasing hip abduction strength increased frontal plane CRP variability from 20-40% of stance phase, primarily in females, and females demonstrated less CRP variability than males in the frontal plane and transverse planes. Overall, the results from this study improve our understanding of the relationships between hip strength, hip muscle activation, and hip kinematics during running in both males and females, which may have implications for knee injury rehabilitation strategies. This dissertation includes unpublished co-authored material.

The work performed in this thesis involves the study of human hip joint kinematics and load analysis. Such analyses are very useful for investigating mobility and natural functionality as well as the variation in motion due to replacement implants. The objective of this study is to design, build and testing of a universal human joint simulator that is configurable to hold several human joints and easily programmable to create the required motion. This was performed by creating a Stewart Platform, which is capable of moving in all six degrees of freedom; the maximum number needed by any human joint. Many specific human joint simulators are available on the market for simulating all major human limbs. These are used for wear testing replacement joints by using high load repetitive motion. These systems have a predetermined limit degree of movement and are very expensive; if one wanted to emulate another joint, one would have to purchase a whole new system. This novel system compromises of a three-phase power supply, Control Area Network with six actuators and drivers, a force reading clamp with strain gauges and data logger. A user friendly computer program was developed that is able to derive joint movement data from two inputs and replicating the movement by driving the platform, as well as recording force and displacement data from the joint. The product would be marketed towards biomechanical researchers and implant designers. Verification of this system was performed by simulating the human hip joint. A known combination of kinematic and force data were inputted into the system for nine different types of activities. The resultant force and joint centre displacement was then compared to see how well the system perform in comparison to the inputted data from a previous study. The outcome of this project is a fully functional machine and configurable program that can create movement data at varying speeds and body weights; which is also able to drive the human joint simulator. The design also costs a fraction of any industrial joint simulator. It is hoped that the simulator will allow easier study of both the kinematics and load analysis within the human joints, with the intent on aiding investigation into mobility and functionality; as well as variation in motion caused by a replacement implant.