Peters, J. (Janne) (2015) Altered biomechanics exist in the kinetic chain of people with Achilles and patellar tendinopathy compared to matched controls: A clinical perspective. thesis, Human Movement Sciences.
Full text available on request.Abstract
Background: People with Achilles and patellar tendinopathy suffer from pain and loss of function of the lower limb kinetic chain. This study aimed to examine if there were biomechanical deficits in participants with tendinopathy in the patellar or Achilles tendon. The second aim was to evaluate the relationship between biomechanical deficits in participants with tendinopathy and pain. Methods: People with Achilles (n=19) or patellar (n=7) tendinopathy were invited to participate in this study. The control groups (n=15 and n=7 respectively) were age (± 2 years) and sex matched to most in the tendinopathy groups. Outcome measures consisted of questionnaires (demographics & VISA-A/VISA-P and TAMPA), tendon imaging, biomechanical testing and pain. Participants had to perform four basic tasks: five squats, five hops, one bilateral and two unilateral broad jumps and a change of direction task, in a markerless motion capture system. Pain was recorded pre- and post-test using the numerical rating scale (NRS) while performing a single leg heel raise on an incline board or a single leg squat on a decline board, for participants with Achilles or patellar tendinopathy respectively. Data analysis: Data analysis consisted of a qualitative analysis, by comparing snapshots from the hop and change of direction task, analysed with chi square tests. Quantitative analysis used Mann Whitney-U tests to assess biomechanical differences between tendinopathy groups and control groups. A linear regression analysis was performed to assess whether there was a relationship between pain and biomechanics. Results: Participants with Achilles tendinopathy demonstrated significantly less knee flexion at initial contact of the hops (p=0.012) and less maximal hip flexion in the change of direction task (P=0.001) compared to controls. Participants with patellar tendinopathy showed significantly less maximal knee flexion at the landing of the broad jump (p=0.026). Five variables had a significant negative correlation with pain. For Achilles tendinopathy these were knee flexion at initial contact of the hops (p=0.022), maximal hip flexion during the landing of the broad jump (p=0.011) and of the change of direction task (p=0.016); for patellar tendinopathy, maximal knee and hip flexion during the landing of the broad jump (p=0.000 and p=0.003). Three of these associations had a relevant negative relationship between pain and the biomechanical variable. Conclusion: This study demonstrated biomechanical differences in clinical movement tests between people with Achilles or patellar tendinopathy and controls. Quantitatively, less range of motion in the lower limb kinetic chain was associated with Achilles and patellar tendinopathy. Pain was negatively related to some biomechanical variables, including maximal hip flexion and knee flexion in the landing of the broad jump and the change of direction task. Larger studies are needed to fully define the biomechanical deficits in people with tendinopathy.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Cook, J. and Elferink-Gemser, M.T. and Akker-Scheek, I. van den and Rosengarten, S. |
| Faculty: | Medical Sciences |
| Date Deposited: | 15 Apr 2022 13:03 |
| Last Modified: | 15 Apr 2022 13:03 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3103 |
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