Relationship between muscle activation and sagittal knee joint biomechanics in patients with patellofemoral pain syndrome: a cross-sectional study
Abstract Background Patellofemoral pain syndrome (PFPS) is one of the most common conditions affecting the knee joint, yet its pathomechanics remain unclear. The aim of this study was to investigate changes in muscle activation and gait patterns and to analyze the relationship between muscle activat...
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BMC
2025-01-01
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| Series: | Knee Surgery & Related Research |
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| Online Access: | https://doi.org/10.1186/s43019-025-00259-4 |
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| author | Byung Sun Choi Soon Bin Kwon Sehyeon Jeon Myeongjun Kim Yunseo Ku Du Hyun Ro Hyuk-Soo Han |
| author_facet | Byung Sun Choi Soon Bin Kwon Sehyeon Jeon Myeongjun Kim Yunseo Ku Du Hyun Ro Hyuk-Soo Han |
| author_sort | Byung Sun Choi |
| collection | DOAJ |
| description | Abstract Background Patellofemoral pain syndrome (PFPS) is one of the most common conditions affecting the knee joint, yet its pathomechanics remain unclear. The aim of this study was to investigate changes in muscle activation and gait patterns and to analyze the relationship between muscle activation and kinetic gait patterns in patients with PFPS. Methods This study included 31 patients with PFPS and 28 healthy volunteers without any symptoms. The sagittal plane motion of the knee joint, representing primary movement of the knee joint, was evaluated to identify changes in gait patterns. Electromyography (EMG) was used to measure muscle activation of vastus medialis (VM), vastus lateralis (VL), semitendinosus (ST), and gastrocnemius (GCM) muscles during gait analysis. Biomechanical features were analyzed during the three phases of the gait cycle; weight acceptance (WA), single limb support (SLS), and swing limb advancement (SLA) (0 ~ 12%, 13 ~ 50%, and 51 ~ 100% of the gait cycle, respectively). Results The average knee extension moment (KEM) during WA was lower in the patient group and no significant differences were observed in the knee flexion angle (KFA). With respect to muscle activation, the patient group showed significantly higher muscle activation of the ST muscle in all phases. As the absolute value of the moment increased, the activation of the VM, VL, and ST muscles increased more rapidly in the patient group, especially when KEM was under −1% body weight × height (Bw × Ht) or over 5% Bw × Ht. Conclusions Patients with PFPS exhibit elevated muscle activation, particularly in response to changes in the knee extension moment, which is likely a compensatory mechanism to manage knee joint loading during gait. These results highlight altered neuromuscular adaptations in PFPS, suggesting targeted therapies may help improve functional outcomes. Level of evidence III, cross-sectional study |
| format | Article |
| id | doaj-art-28d5a5a9412044cbba6b8f117762971d |
| institution | Kabale University |
| issn | 2234-2451 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Knee Surgery & Related Research |
| spelling | doaj-art-28d5a5a9412044cbba6b8f117762971d2025-01-26T12:39:22ZengBMCKnee Surgery & Related Research2234-24512025-01-013711810.1186/s43019-025-00259-4Relationship between muscle activation and sagittal knee joint biomechanics in patients with patellofemoral pain syndrome: a cross-sectional studyByung Sun Choi0Soon Bin Kwon1Sehyeon Jeon2Myeongjun Kim3Yunseo Ku4Du Hyun Ro5Hyuk-Soo Han6Department of Orthopedic Surgery, Seoul National University Hospital, Seoul National University College of MedicineDepartment of Neurology, Columbia University Irving Medical CenterSeoul National University College of MedicineSeoul National University College of MedicineDepartment of Biomedical Engineering, Chungnam National University College of MedicineDepartment of Orthopedic Surgery, Seoul National University Hospital, Seoul National University College of MedicineDepartment of Orthopedic Surgery, Seoul National University Hospital, Seoul National University College of MedicineAbstract Background Patellofemoral pain syndrome (PFPS) is one of the most common conditions affecting the knee joint, yet its pathomechanics remain unclear. The aim of this study was to investigate changes in muscle activation and gait patterns and to analyze the relationship between muscle activation and kinetic gait patterns in patients with PFPS. Methods This study included 31 patients with PFPS and 28 healthy volunteers without any symptoms. The sagittal plane motion of the knee joint, representing primary movement of the knee joint, was evaluated to identify changes in gait patterns. Electromyography (EMG) was used to measure muscle activation of vastus medialis (VM), vastus lateralis (VL), semitendinosus (ST), and gastrocnemius (GCM) muscles during gait analysis. Biomechanical features were analyzed during the three phases of the gait cycle; weight acceptance (WA), single limb support (SLS), and swing limb advancement (SLA) (0 ~ 12%, 13 ~ 50%, and 51 ~ 100% of the gait cycle, respectively). Results The average knee extension moment (KEM) during WA was lower in the patient group and no significant differences were observed in the knee flexion angle (KFA). With respect to muscle activation, the patient group showed significantly higher muscle activation of the ST muscle in all phases. As the absolute value of the moment increased, the activation of the VM, VL, and ST muscles increased more rapidly in the patient group, especially when KEM was under −1% body weight × height (Bw × Ht) or over 5% Bw × Ht. Conclusions Patients with PFPS exhibit elevated muscle activation, particularly in response to changes in the knee extension moment, which is likely a compensatory mechanism to manage knee joint loading during gait. These results highlight altered neuromuscular adaptations in PFPS, suggesting targeted therapies may help improve functional outcomes. Level of evidence III, cross-sectional studyhttps://doi.org/10.1186/s43019-025-00259-4Patellofemoral pain syndromeGait analysisElectromyography |
| spellingShingle | Byung Sun Choi Soon Bin Kwon Sehyeon Jeon Myeongjun Kim Yunseo Ku Du Hyun Ro Hyuk-Soo Han Relationship between muscle activation and sagittal knee joint biomechanics in patients with patellofemoral pain syndrome: a cross-sectional study Knee Surgery & Related Research Patellofemoral pain syndrome Gait analysis Electromyography |
| title | Relationship between muscle activation and sagittal knee joint biomechanics in patients with patellofemoral pain syndrome: a cross-sectional study |
| title_full | Relationship between muscle activation and sagittal knee joint biomechanics in patients with patellofemoral pain syndrome: a cross-sectional study |
| title_fullStr | Relationship between muscle activation and sagittal knee joint biomechanics in patients with patellofemoral pain syndrome: a cross-sectional study |
| title_full_unstemmed | Relationship between muscle activation and sagittal knee joint biomechanics in patients with patellofemoral pain syndrome: a cross-sectional study |
| title_short | Relationship between muscle activation and sagittal knee joint biomechanics in patients with patellofemoral pain syndrome: a cross-sectional study |
| title_sort | relationship between muscle activation and sagittal knee joint biomechanics in patients with patellofemoral pain syndrome a cross sectional study |
| topic | Patellofemoral pain syndrome Gait analysis Electromyography |
| url | https://doi.org/10.1186/s43019-025-00259-4 |
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