Orientador: Ricardo Machado Leite de Barros / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação Física / Made available in DSpace on 2018-08-26T09:36:38Z (GMT). No. of bitstreams: 1 Sobral_JulianaMorenoCarmona_M.pdf: 1814656 bytes, checksum: 1821bbfffb02f428ed7b8b9ef7f46e78 (MD5) Previous issue date: 2014 / Resumo: O objetivo geral do trabalho foi propor e avaliar um método para análise cinemática tridimensional da articulação femoropatelar a partir de marcadores externos, durante a execução de saltos verticais. Para isso, foi desenvolvida uma configuração específica do sistema de análise, com seis câmeras industriais posicionadas de forma a garantir um bom valor de exatidão da medida gerada. A frequência de aquisição foi 100 Hz. O rastreamento dos segmentos corporais analisados e a reconstrução das respectivas coordenadas 3D foram realizados no software Dvideo. Já a orientação e modelagem foram feitas no software Visual 3D®. Neste estudo foram avaliados doze sujeitos saudáveis (grupo controle) e cinco sujeitos com síndrome femoropatelar em ambos os joelhos (grupo SFP). As variáveis analisadas foram a exatidão da medida do sistema, a distância entre os marcadores da patela, os ângulos de rotação do joelho e os ângulos de rotação e translação da articulação femoropatelar. A análise dos resultados foi feita após subdividir o movimento do salto em função do ângulo de flexão do joelho, em duas fases distintas, a decolagem (agachamento e impulsão) e a aterrissagem (aterrissagem e retorno à posição inicial). Os ângulos de rotação e valores de translação obtidos foram similares para os membros inferiores para as duas articulações analisadas. Já em relação às fases do movimento, todos os valores apresentaram menor magnitude na aterrissagem, uma vez que a amplitude de movimento de flexão do joelho nesta fase foi menor. Durante o agachamento, ambos os grupos apresentaram flexão, deslocamento medial, posterior e inferior da AFP, porém em menor amplitude no grupo SFP. A análise de confiabilidade apresentou valores de concordância excelente, sugerindo que o método utilizado gere dados consistentes. Podemos concluir que o modelo proposto foi capaz de detectar movimentação da patela em relação ao fêmur no eixo transversal para a rotação e nos eixos transversal, ântero-posterior e longitudinal para translação, em ambos os grupos estudados / Abstract: The major aim of this study was to propose and evaluate a method for three-dimensional kinematic analysis of the patellofemoral joint based on external markers while performing vertical jumps. For this, a specific configuration of the analysis system was developed, with six industrial cameras positioned to ensure a good accuracy of the measurement data. The acquisition frequency was 100 Hz. The analyzed body segments tracking and the reconstruction of their 3D coordinates were performed in Dvideo software. Their orientation and modeling were done in Visual 3D ® software. In this study we evaluated twelve healthy subjects (control group) and five subjects with patellofemoral syndrome in both knees (SFP group). The analyzed variables were the accuracy of the system, the distance between the markers of the patella, knee and patellofemoral rotation angles and translation values of the patellofemoral joint. The data analysis was made after subdividing the jump movement according to the angle of knee flexion in two distinct phases, takeoff (squat and propulsion) and landing (landing and return to starting position). The knee and patellofemoral obtained rotation angles and translation values were similar for both lower limbs. In relation to the vertical jump phases, all values were lower in the landing phase, due to the knee range of motion at this stage has been equally lower. During the squat, both groups showed flexion, medial, posterior and inferior displacement of the patellofemoral joint, but the SFP group showed smaller values. The reliability analysis showed excellent agreement values, suggesting that the method used in this study is capable to generate consistent data. We can conclude that the proposed model was able to detect patellar movement relative to the femur in the transverse axis for the rotation and in the transverse, anteroposterior and longitudinal axes for translation, in both groups / Mestrado / Biodinamica do Movimento e Esporte / Mestra em Educação Física

Dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban University of Technology, 2010. / Motion palpation is used to assess the functional status of a joint and is defined as “The manual palpation of bony structures and soft tissues, through pressure applied in various directions of joint motion to ascertain areas of joint hypomobility and hypermobility.” Motion palpation is a collection of manual examination procedures, used to identify the site and characteristics of altered joint motion and which has been an important part of chiropractic since its inception. One of the most important goals for any clinical instrument is for it to have good reliability and reproducibility, this is because the clinical value of a test must be demonstrated before the results are considered valid. The extent to which a repeated test will produce the same result when evaluating an unchanged characteristic is its reliability. Reliability is evaluated by multiple blinded measurements performed on a sample of subjects. Inter-examiner reliability evaluates the consistency of different examiners and is determined through repeated assessment by two or more raters. Objective The aim of this study was to determine the inter-examiner reliability of motion palpation of knee joints with patellofemoral pain syndrome and asymptomatic knee joints, and to compare the inter-examiner reliability of motion palpation between the two groups. Method This quantitative, inter-examiner, clinical reliability study, included 30 patients each with one knee with patellofemoral pain syndrome and one asymptomatic knee. Each patient had both of their knees motion palpated by three independent examiners blinded to which was the symptomatic knee. The examiners were senior student interns at the DUT Chiropractic Clinic. The motion palpation findings were recorded and statistically analyzed through the SPSS statistical package. Fleiss Kappa statistic was used to give a Kappa score for each direction of motion palpation and these scores evaluated the inter-examiner reliability of motion palpation in the symptomatic and the asymptomatic knee. A comparison of the inter-examiner reliability of motion palpation between the two groups was performed using a paired Wilcoxin signed ranks test. Results The Kappa scores for motion palpation ranged from -0.2081 to 0.1802 for the symptomatic knee joint and -0.2836 to 0.0339 for the asymptomatic knee. This shows poor agreement in both cases. There was no significant difference in Kappa values (p= 0.609) for the two groups for the Wilcoxin signed ranks test and the number of positive and negative ranks were similar. This indicates that the reliability of motion palpation in both groups was similar. Conclusion It was concluded that inter-examiner reliability of motion palpation of the knee joint was poor in knees with patellofemoral pain syndrome and in knees that were asymptomatic. Motion palpation was found to be equally reliable in both groups, indicating that motion palpation of a symptomatic joint does not improve its reliability. This research suggests that motion palpation should be used together with other diagnostic tests to identify patellofemoral pain syndrome as it is not a reliable tool when used in isolation.

Thesis (M.Thec.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xiii, 110 leaves ; ill. ; 30 cm / According to Wood (1998), patellofemoral pain syndrome (PFPS) refers to a syndrome that comprises of the following signs and symptoms: anterior knee pain, inflammation, imbalance, instability, or any combination thereof. Prevailing literature suggests that the presence of myofascial trigger points (MFTP’s) in quadriceps femoris (QF) muscle could result in a combination of the following signs and symptoms: - Retro- or peripatella pain, - Weakness of the quadriceps muscle (Chaitow and DeLany, 2002) - Loss of full lengthening (Travell and Simons, 1983:248-250) The aetiology of PFPS is poorly understood (Kannus et al. 1999). The current trend in literature suggests an extensor mechanism dysfunction as the most probable aetiology (Galantly et al., 1994; Juhn, 1999). There appears to be a clinical overlap between the two syndromes, in terms of an extensor mechanism dysfunction and of signs and symptoms. The aim of this investigation was to evaluate the role of active myofascial trigger points in the vastus lateralis (VL) muscle as perpetuating, causative or concomitant factors in the alteration of VL/VM Total Work (TW) in PFPS in distance runners.

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2006 18, xvii, 157, 14 leaves, Annexures A-K / The aim of this study was to assess the inter-examiner reliability of motion palpation of the patella, in both pathological (osteoarthritis) as well as functional (patellofemoral pain syndrome) conditions, in order to assess the validity of this assessment tool, which is commonly used as a method in identifying restricted patella motion.

Thesis (M.Tech,: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2005 xiii, 62, 19 leaves :|bill. ;|c30 cm / To document the relationship between total work and myofascial trigger points in the vastus lateralis and vastus medialis portion of the quadriceps femoris muscle, whilst providing baseline graphs of these muscles with the use of a Cybex 700 Isokinetic Dynanometer in long distance runners both with and without patellofemoral pain syndrome. Methods: A quantitative, non-intervention clinical exploratory study. Fifty participants were divided into two groups, Group A (40 symptomatics) and Group B (10 asymptomatics). Both groups were screened for vastus lateralis and vastus medialis trigger points. Subjective data was obtained from Group A only, using the Numerical Pain Rating Scale and the Patient Specific Functional Scale. Objective data was obtained from both groups using the algometer, Myofascial Diagnostic Scale, and the Cybex 700 Isokinetic Dynanometer. For descriptive analysis frequency tabulations, box and whisker plots were used to display distributions graphically. Comparisons of categorical and quantitative variables between independent groups were run using chi square and Mann-Whitney testing consecutively. Finally Spearman’s correlation, multivariate generalized linear modelling and repeated measures ANOVA were also used. All statistical analysis was completed at the 95% (p<0.05) level of confidence.

Thesis (PhD (Mechanical and Mechatronic Engineering))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: A methodology to facilitate analysis of dynamic subject-specific patellofemoral function is presented. An enhanced understanding of patellofemoral biomechanics will enable orthopaedic surgeons to identify the mechanisms responsible for imbalances in the joint stabilisers, while also providing objective information on which to base treatment methods. Dynamic patellofemoral function of three volunteers was simulated with a musculoskeletal computational model. The individuals underwent scans from which three-dimensional models of their patellofemoral joints were constructed. Skeletal muscles and soft tissue stabilisers were added to the skeletal models, after which subject-specific motion was simulated. After trochlear engagement, the patellae of the volunteers followed a lateral path, whereas patella tilt was subject-specific. Comparison of the predicted tilt and mediolateral position values at 30 degrees knee flexion to in-vivo MRI values showed a mean accuracy of 62.1 % and 96.9 % respectively. The patellofemoral contact load . quadriceps tendon load ratio varied between 0.7 and 1.3, whereas the mediolateral load component . resultant load ratio ranged between 0 and 0.4. Both parameters. values were similar to previous findings. The medial patellofemoral ligament tension decreased with knee flexion, while the patellar tendon-quadriceps tendon ratio followed a similar trend to that of previous findings (varied between 0.4 and 1.2). After induction of a tubercle osteotomy in the coronal plane, Volunteer One.s patella engaged the trochlear groove at an earlier knee flexion angle, while the patella of Volunteer Two only underwent a small medial displacement. Finite element analyses were employed to investigate the influence of the osteotomy on the patellofemoral pressure distribution. The mean pressure in Volunteer One.s patellofemoral joint was alleviated (17 % smaller) at all angles of flexion with the exception of 60 degrees (12 % greater). Pressure in Volunteer Two.s joint was alleviated at 30 and 45 degrees knee flexion (6 % smaller), while it was elevated (9.1 % greater) at other angles of flexion. Two commercial patellofemoral prostheses were tested on the three Volunteers. joints in the virtual environment. Prosthesis Two delivered patella shift and tilt patterns similar to the baseline values. Patellar tendon tension was slightly greater after resurfacing, with the tensions elevated most with Prosthesis Two. Medial patellofemoral ligament tension was reduced most with Prosthesis Two, while lateral retinaculum tension was increased slightly. Prosthesis Two was the best candidate to reproduce patella kinematics, while the patellofemoral kinetics was largely independent from the type of prosthesis used. The prostheses performed worse for Volunteer Three, supporting the need for the development of patient-specific prostheses. Three validated subject-specific musculoskeletal models facilitated the analysis of the individuals. patellofemoral biomechanics. The technique can potentially be employed by orthopaedic surgeons to visualise the change that an osteotomy or patellofemoral arthroplasty might induce on an individual.s patellofemoral joint. This technique might aid in the development of a tool to assist biomedical engineers in the development of new patellofemoral prostheses. Most importantly, the outcome of surgical intervention may be predicted beforehand, and a treatment procedure may be tailored to optimally fit the patellofemoral biomechanics of that individual. / AFRIKAANSE OPSOMMING: 'n Ondersoekmetode van die dinamiese gedrag van pasiënt-spesifieke patellofemorale gewrigte word beskryf. Indien die patellofemorale biomeganika beter verstaan word, kan ortopediese chirurge die meganismes wat verantwoordelik is vir oneffektiewe stabiliseerders identifiseer en behandeling op objektiewe bevindinge baseer. Die dinamiese patellofemorale funksie van drie vrywilligers is gesimuleer m.b.v. `n spier-skelet rekenaarmodel. Drie-dimensionele modelle van die individue se patellofemorale gewrig is gekonstrueer m.b.v. skanderings. Die skeletspiere en sagte ondersteuningsweefsel is tot die model toegevoeg, voordat vrywilliger-spesifieke beweging gesimuleer is. Die knieskywe van die vrywilligers het `n laterale pad gevolg nadat dit die groef binnegetree het, met die tiltwaardes uniek vir elke vrywilliger. Vergelyking van die beraamde knieskyf mediolaterale tilt en posisies by 30 grade fleksie met in-vivo magnetiese resonansieskandering waardes het `n akkuraatheid van 62.1 % en 96.9 % respektiewelik getoon. Die patellofemorale kontaklas-kwadriseps seningspanning verhouding het gewissel tussen 0.7 en 1.3; asook die mediale komponent – resultante komponent patellofemorale kontaklas wat gewissel het tussen 0 en 0.4. Beide parameters se waardes was soortgelyk aan voorheen-gepubliseerde data. Die mediale patellofemorale ligamentspanning het afgeneem met fleksie. Die patella sening-kwadriseps seningspanning verhouding was soortgelyk aan vorige gepubliseerde waardes en het gewissel tussen 0.4 en 1.2. Nadat 'n tuberkel-osteotomie in die koronale vlak aangebring is, het Vrywilliger Een se patella die femorale groef vroeër binnegetree. Vrywilliger Twee se patella het slegs `n mediale verskuiwing ondergaan. Eindige element analises is ingespan om die effek van die osteotomie op die spanningsverspreiding in die patellofemorale gewrig te ondersoek. Die gemiddelde spanning in Vrywilliger Een se gewrig was minder by alle hoeke van fleksie (17 % minder), met uitsondering van die spanning by 60 grade (12 % meer). Die spanning in Vrywilliger Twee se gewrig was minder by 30 en 45 grade (6 % minder), maar hoër by ander hoeke (9.1 % meer). Twee kommersiële patellofemorale prosteses is getoets op die drie Vrywilligers d.m.v. die model. Prostese Twee het die knieskyf-kinematika die beste nageboots. Die patella-seningspanning was effens groter na die vervanging. Prostese Twee het gesorg vir die grootste toename. Die mediale patellofemorale ligamentspanning was die kleinste toe Prostese Twee gebruik is, maar dit het gesorg vir effense hoër laterale retinakulumlaste. Die analises het getoon dat Prostese Twee die beste kandidaat is om die korrekte kinematika te herbewerkstellig. Die kinetika daarteenoor was onafhanklik van die tipe prostese wat gebruik is. Geeneen van die twee prosteses was geskik vir Vrywilliger Drie nie, wat as motivering vir die ontwikkeling van pasiënt-spesifieke prosteses dien. Drie bekragtigde vrywilliger-spesifieke spier-skelet modelle het die analise van patellofemorale biomeganika bewerkstellig. Die tegniek het die potensiaal om ortopediste in staat te stel om die effek van `n osteotomie of patellofemorale vervanging te visualiseer. Die tegniek kan verder gebruik word deur biomediese ingenieurs in die vervaardiging van nuwe patellofemorale prosteses. Meer belangrik is die feit dat die resultaat van chirurgiese ingryping voorspel kan word en optimale behandelingsprosedures beplan kan word vir die patellofemorale biomeganika van `n individu.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / According to Wood (1998), patellofemoral pain syndrome (PFPS) refers to a syndrome that comprises of the following signs and symptoms: anterior knee pain, inflammation, imbalance, instability, or any combination thereof. Prevailing literature suggests that the presence of myofascial trigger points (MFTP’s) in quadriceps femoris (QF) muscle could result in a combination of the following signs and symptoms: - Retro- or peripatella pain, - Weakness of the quadriceps muscle (Chaitow and DeLany, 2002) - Loss of full lengthening (Travell and Simons, 1983:248-250) The aetiology of PFPS is poorly understood (Kannus et al. 1999). The current trend in literature suggests an extensor mechanism dysfunction as the most probable aetiology (Galantly et al., 1994; Juhn, 1999). There appears to be a clinical overlap between the two syndromes, in terms of an extensor mechanism dysfunction and of signs and symptoms. The aim of this investigation was to evaluate the role of active myofascial trigger points in the vastus lateralis (VL) muscle as perpetuating, causative or concomitant factors in the alteration of VL/VM Total Work (TW) in PFPS in distance runners.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, 2005. / To document the relationship between total work and myofascial trigger points in the vastus lateralis and vastus medialis portion of the quadriceps femoris muscle, whilst providing baseline graphs of these muscles with the use of a Cybex 700 Isokinetic Dynanometer in long distance runners both with and without patellofemoral pain syndrome. Methods: A quantitative, non-intervention clinical exploratory study. Fifty participants were divided into two groups, Group A (40 symptomatics) and Group B (10 asymptomatics). Both groups were screened for vastus lateralis and vastus medialis trigger points. Subjective data was obtained from Group A only, using the Numerical Pain Rating Scale and the Patient Specific Functional Scale. Objective data was obtained from both groups using the algometer, Myofascial Diagnostic Scale, and the Cybex 700 Isokinetic Dynanometer. For descriptive analysis frequency tabulations, box and whisker plots were used to display distributions graphically. Comparisons of categorical and quantitative variables between independent groups were run using chi square and Mann-Whitney testing consecutively. Finally Spearman’s correlation, multivariate generalized linear modelling and repeated measures ANOVA were also used. All statistical analysis was completed at the 95% (p<0.05) level of confidence. / M

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2006. / The aim of this study was to assess the inter-examiner reliability of motion palpation of the patella, in both pathological (osteoarthritis) as well as functional (patellofemoral pain syndrome) conditions, in order to assess the validity of this assessment tool, which is commonly used as a method in identifying restricted patella motion. / M

Author: Bc. Petra Mertová Title: The effect of kinesiotape application on rheological properties of the knee joint with chondromalacia patellae Problem definition: Chondromalacia patellae is a very frequent diagnosis related to knee injuries. Diagnosing chondromalacia is very difficult. Knee arthroscopy is the best method for evaluating the cartilage condition, however this technique is invasive. Kinesiotaping is a therapeutic method extensively used to affect knee pain. Patellar taping is an effective method in improving symptoms resulting from patellofemoral joint problems, nevertheless the evaluation of its effect has not yet been objectively investigated. Aim of the thesis: The aim of this study is firstly to discover the possibility to noninvasively detect chondromalacia patellae using the method of biorheometry and secondly to discover the impact of kinesiotaping on rheological properties of the knee joint with chondromalacia patellae. Method: The designed experiment was performed as a pilot case study using the method of biorheometry. The history of the patient was monitored using a questionnaire and by a clinical examination of the knee joint. Two questionnaires were created to evaluate the functional state of the knee joint. Measurements were done on a special device called biorheometer....