Year of Publication

2012

Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation

College

Education

Department

Exercise Science

First Advisor

Dr. Timothy L. Uhl

Abstract

It has been suggested that Patellofemoral Pain (PFP) may be the result of a coordinate state which exhibits less joint coordination variability. The ability to relate joint coordination variability to PFP pathology could have many clinical uses; however, evidence to support clinical application is lacking. Vector coding’s coupling angle variability (CAV) has been introduced as a possible analysis method to quantify joint coordination variability. The purpose of this study was to assess the clinical usefulness of CAV measures from a dynamical systems perspective. This involved establishing the precision limits of CAV measures when physiological conditions are held constant, altering control parameters of knee pain and population then determining if the observed changes in CAV were clinically meaningful.

20 female recreational runners with PFP and 21 healthy controls performed a treadmill acclimation protocol then ran at a self-selected pace for 15 minutes. 3-D kinematics, force plate kinetics, knee pain and perceived exertion were recorded each minute. CAV were calculated for six knee-ankle combinations for 2 sets of 5 non-consecutive stride cycles at each capture period. Data were selected for the PFP group at a high (=>3) and low (<=high-2) pain level in a non-exhausted state (<14). Healthy data were used from the 11th minute of the running. Levels of agreement were performed between the 2 sets of CAV measures for both populations, a paired t-test compared low to high pain CAV measures and independent t-tests compared populations at the high pain state.

Several CAV measures showed a significant increase in value with an increase in pain and were significantly greater for the PFP group. None of the observed changes exceeded the precision limits of all CAV measures investigated. These results do not agree with previous claims that less variability is indicative of pathology but rather the opposite. This suggests that there might be an optimal amount of variability to maintain a healthy coordinate state with deviations in any direction being detrimental. However; due to the volatile nature of CAV measures, the clinical use of CAV is not recommended using current analysis methods since changes observed weren’t considered clinically meaningful.

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