Spatiotemporal Gait Parameters and Variability in Individuals with Patellofemoral Pain Syndrome: A Comparative Study

Subject Areas : Exercise Physiology and Performance

Ali Salimi ^{1 *} , Zahra Bozorgzadeh Haghighi ²

1 - Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran
2 - Faculty of Physical Education and Sport Sciences, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

Received: 2025-05-06 Accepted : 2025-06-06 Published : 2025-06-10

Keywords: Patellofemoral Pain, Spatiotemporal Parameters, Variability, Gait,

Abstract :

Background: Patellofemoral pain syndrome (PFPS) is one of the most prevalent musculoskeletal disorders among young females, potentially affecting gait patterns and increasing the risk of secondary injuries.

Objective: To compare spatiotemporal gait parameters and their variability between females with PFPS and healthy controls.

Design: This applied study used a quasi-experimental, post-event causal-comparative design.

Participants: Twenty-four females aged 18–25 were divided into two groups: PFPS (n=11) and healthy controls (n=13). Participants were selected via purposive and convenience sampling.

Methods: Participants walked for one minute at their self-selected speed on a treadmill while gait data were recorded using two IMU sensors. Parameters such as stride length, stride time, walking speed, cadence, heel clearance, and stance/swing percentages were extracted across 20 gait cycles. Gait variability was calculated as the standard deviation of each parameter. Data were analyzed using MANOVA at a significance level of 0.05.

Results: Significant differences were found in stride length and walking speed between the groups (p<0.05), with higher values in the healthy group. No significant differences were observed in other parameters or in gait variability.

Conclusion: Reduced stride length and speed in PFPS individuals may reflect compensatory mechanisms due to pain. These alterations may cause abnormal joint loading, increasing the risk of secondary injuries and long-term movement disorders.

References:

1. Collins NJ, Barton CJ, Van Middelkoop M, Callaghan MJ, Rathleff MS, Vicenzino BT, et al. 2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017. British journal of sports medicine. 2018;52(18):1170-8.
2. Lack S, Barton C, Sohan O, Crossley K, Morrissey D. Proximal muscle rehabilitation is effective for patellofemoral pain: a systematic review with meta-analysis. British journal of sports medicine. 2015;49(21):1365-76.
3. Neal BS, Barton CJ, Gallie R, O’Halloran P, Morrissey D. Runners with patellofemoral pain have altered biomechanics which targeted interventions can modify: a systematic review and meta-analysis. Gait & posture. 2016;45:69-82.
4. Nakagawa TH, Moriya ÉT, Maciel CD, Serrão FV. Trunk, pelvis, hip, and knee kinematics, hip strength, and gluteal muscle activation during a single-leg squat in males and females with and without patellofemoral pain syndrome. Journal of orthopaedic & sports physical therapy. 2012;42(6):491-501.
5. Manske RC, Davies GJ. Examination of the patellofemoral joint. International journal of sports physical therapy. 2016;11(6):831.
6. Cook C, Hegedus E, Hawkins R, Scovell F, Wyland D. Diagnostic accuracy and association to disability of clinical test findings associated with patellofemoral pain syndrome. Physiotherapy Canada. 2010;62(1):17-24.
7. Angelini L, Di Puccio F, Zander T, Schmidt H. Influence of arm motion on spatio-temporal gait parameters and on force data. IOSR Journal of Sports and Physical Education. 2016;3:12-7.
8. Yoon J, Park J, Park K, Jo G, Kim H, Jang W, et al. The effects of additional arm weights on arm-swing magnitude and gait patterns in Parkinson’s disease. Clinical Neurophysiology. 2016;127(1):693-7.
9. Carmo A, Kleiner A, Costa P, Barros R. Three-dimensional kinematic analysis of upper and lower limb motion during gait of post-stroke patients. Brazilian Journal of Medical and Biological Research. 2012;45:537-45.
10. Paoloni M, Mangone M, Fratocchi G, Murgia M, Saraceni VM, Santilli V. Kinematic and kinetic features of normal level walking in patellofemoral pain syndrome: more than a sagittal plane alteration. Journal of biomechanics. 2010;43(9):1794-8.
11. Pohl MB, Patel C, Wiley JP, Ferber R. Gait biomechanics and hip muscular strength in patients with patellofemoral osteoarthritis. Gait & posture. 2013;37(3):440-4.
12. Codorean II, Codorean IB. Clinical-MRI correlations of anterior knee pain: Common and uncommon causes: Springer Nature; 2023.
13. Arazpour M, Bahramian F, Abutorabi A, Nourbakhsh ST, Alidousti A, Aslani H. The effect of patellofemoral pain syndrome on gait parameters: a literature review. Archives of Bone and Joint Surgery. 2016;4(4):298.
14. Willson JD, Sharpee R, Meardon SA, Kernozek TW. Effects of step length on patellofemoral joint stress in female runners with and without patellofemoral pain. Clinical biomechanics. 2014;29(3):243-7.
15. Bazett-Jones DM, Neal BS, Legg C, Hart HF, Collins NJ, Barton CJ. Kinematic and kinetic gait characteristics in people with patellofemoral pain: a systematic review and meta-analysis. Sports Medicine. 2023;53(2):519-47.
16. Barton CJ, Lack S, Hemmings S, Tufail S, Morrissey D. The ‘Best Practice Guide to Conservative Management of Patellofemoral Pain’: incorporating level 1 evidence with expert clinical reasoning. British journal of sports medicine. 2015;49(14):923-34.
17. Freddolini M, Placella G, Gervasi G, Morello S, Cerulli G. Quadriceps muscles activity during gait: comparison between PFPS subjects and healthy control. Musculoskeletal surgery. 2017;101:181-7.
18. Baellow A, Glaviano NR, Hertel J, Saliba SA. Lower extremity biomechanics during a drop-vertical jump and muscle strength in women with patellofemoral pain. Journal of Athletic Training. 2020;55(6):615-22.
19. Arrebola LS, de Carvalho RT, Wun PYL, de Oliveira PR, Dos Santos JF, de Oliveira VGC, et al. Investigation of different application techniques for Kinesio Taping® with an accompanying exercise protocol for improvement of pain and functionality in patients with patellofemoral pain syndrome: A pilot study. Journal of Bodywork and Movement Therapies. 2020;24(1):47-55.
20. Young PMM, Dingwell JB. Voluntary changes in step width and step length during human walking affect dynamic margins of stability. Gait & posture. 2012;36(2):219-24.