title: Factors associated with visually assessed quality of movement during a lateral step-down test among individuals with patellofemoral pain.
abstract: METHODS
  Cross-sectional.
  
  
  OBJECTIVE
  To determine what physical measures are associated with visually assessed quality of movement among patients with patellofemoral pain (PFP).
  
  
  BACKGROUND
  An altered movement pattern has been implicated as a risk factor for PFP. An understanding of physical measures associated with an altered movement pattern could potentially help guide prevention and management efforts in patients with PFP.
  
  
  METHODS
  Seventy-nine (40 women) Israel Defense Forces soldiers referred to physical therapy with a diagnosis of PFP were included. Movement pattern was assessed visually during a lateral step-down test and rated as "good" or "moderate," based on previously established criteria. Weight-bearing and non-weight-bearing ankle dorsiflexion (DF) range of motion (ROM); hip internal and external rotation ROM; and hip abduction, hip external rotation, and knee extension strength were also assessed. Differences in physical measures between those with good versus moderate quality of movement were assessed.
  
  
  RESULTS
  Weight-bearing DF ROM was more limited among participants with a moderate quality of movement compared to those with a good quality of movement (P<.01). Among men, non-weight-bearing DF ROM was more limited in those with a moderate quality of movement as well (P<.01). In addition, quality of movement was associated with weight-bearing DF ROM for both women (r = -0.39, P = .01) and men (r = -0.46, P<.01), and with non-weight-bearing DF ROM for men (r = -0.66, P<.01). When the subgroup of participants who exhibited more than 25° of non-weight-bearing DF ROM was assessed, those with a good quality of movement displayed greater hip external rotator and knee extensor muscle strength compared with those with a moderate quality of movement (P<.01).
  
  
  CONCLUSIONS
  Ankle DF ROM should be assessed when patients with PFP demonstrate a lower quality of movement during a lateral step-down test. Lower hip muscle strength may be associated with lower quality of movement among patients with relatively greater ankle DF ROM.
authors.affiliation: Department of Physiotherapy, Ariel University, Ariel, Israel.
authors.forename: Alon
authors.initials: A
authors.lastname: Rabin
authors.forename: Zvi
authors.initials: Z
authors.lastname: Kozol
authors.forename: Uria
authors.initials: U
authors.lastname: Moran
authors.forename: Arye
authors.initials: A
authors.lastname: Efergan
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Geffen
authors.forename: Aharon S
authors.initials: AS
authors.lastname: Finestone
mesh_terms: D000328:Adult; D000842:Ankle / Q000503:physiopathology*; D018771:Arthralgia / Q000175:diagnosis* / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D006615:Hip / Q000503:physiopathology*; D006801:Humans; D007557:Israel; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008889:Military Personnel; D009068:Movement; D053580:Muscle Strength / Q000502:physiology; D016059:Range of Motion, Articular; D016474:Weight-Bearing; D055815:Young Adult
keywords: ankle; anterior knee pain; chondromalacia; hip; patella