The electromyography of knee muscles in people with patellofemoral pain syndrome: systematic review

Document Type : Review Article

Authors

1 Students` Research Office, MSc Student in Physiotherapy, School of Rehabilitation Scienses, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Assistant Professor in Physiotherapy. Department of Physiotherapy School of Rehabilitation Scienses, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Professor in Physiotherapy. Department of Physiotherapy, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 PhD in Biostatistics, Assosiated Professor, School of Rehabilitation Scienses, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background and Aim: Patellofemoral Pain Syndrome (PFPS) is known as one of the most frequent knee diseases in athletic and non athletic populations and the most frequent causes of anterior or retropatellar knee pain. Despite the prevalence of PFPS, its etiology is not clearly known and has been reported to be multifactorial. Managing patients with PFPS is often challenging, in part because of a lack of consensus regarding its etiology and treatment. Electromyography (EMG) is a well-known method to study the etiology of PFPS. The aim of the present study was a systematic review of studies conducting electromyography of knee muscles in people with and without PFPS.
Materials and Methods: Databases of PubMed, ScienceDirect, and Google Scholar were searched for studies published in English between 2000 and 2014. The terms: PFPS, EMG, muscle imbalance, motor control, vastii muscles, and knee muscles as well as the combination of these terms were used.
Results: Among almost 35 relevant studies, 9 studies were selected. Based on the muscles, the studies were divided into two groups: 1) The studies that assessed vastii muscles, and 2) The studies that compared vastii and hamstring muscles.
Conclusion: Studies had used diverse EMG signal processing and testing protocols. The findings tended to support the notion that alteration in the electrical signal of the knee muscles is founded in individuals with PFPS, but the pattern of this alteration is still a matter of question. Due to the varietry of studies and their results, it can be concluded that the evidence, although existant, is not convincing yet.

Keywords


  1. Besier TF, Fredericson M, Gold GE, Beaupré GS, Delp SL. Knee muscle forces during walking and running in patellofemoral pain patients and pain-free controls. Journal of biomechanics. 2009;42(7):898-905.##
  2. Cowan SM, Hodges PW, Bennell KL, Crossley KM. Altered vastii recruitment when people with patellofemoral pain syndrome complete a postural task. Archives of physical medicine and rehabilitation. 2002;83(7):989-95.##
  3. Ott B, Cosby NL, Grindstaff TL, Hart JM. Hip and knee muscle function following aerobic exercise in individuals with patellofemoral pain syndrome. Journal of Electromyography and Kinesiology. 2011;21(4):631-7. ##
  4. Cowan SM, Bennell KL, Crossley KM, Hodges PW, McConnell J. Physical therapy alters recruitment of the vasti in patellofemoral pain syndrome. Medicine and science in sports and exercise. 2002;34(12):1879-85. ##
  5. Cowan SM, Bennell KL, Hodges PW, Crossley KM, McConnell J. Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome. Archives of physical medicine and rehabilitation. 2001;82(2):183-9. ##
  6. D ieter BP, McGowan CP, Stoll SK, Vella CA. Muscle activation patterns and patellofemoral pain in cyclists. Med Sci Sports Exerc. 2014;46(4):753-61. ##
  7. Wong YM. Recording the vastii muscle onset timing as a diagnostic parameter for patellofemoral pain syndrome: fact or fad?. Physical Therapy in Sport. 2009;10(2):71-4. ##
  8. Boling MC, Bolgla LA, Mattacola CG, Uhl TL, Hosey RG. Outcomes of a weight-bearing rehabilitation program for patients diagnosed with patellofemoral pain syndrome. Archives of physical medicine and rehabilitation. 2006;87(11):1428-35. ##
  9. Bolgla LA, Malone TR, Umberger BR, Uhl TL. Comparison of hip and knee strength and neuromuscular activity in subjects with and without patellofemoral pain syndrome. International journal of sports physical therapy. 2011;6(4):285. ##
  10. Stensdotter AK, Hodges P, Öhberg F, Häger-Ross C. Quadriceps EMG in open and closed kinetic chain tasks in women with patellofemoral pain. Journal of motor behavior. 2007;39(3):194-202. ##
  11. Boling M, Padua D, Marshall S, Guskiewicz K, Pyne S, Beutler A. Gender differences in the incidence and prevalence of patellofemoral pain syndrome. Scandinavian journal of medicine & science in sports. 2010;20(5):725-30. ##
  12. Patil S, Dixon J, White LC, Jones AP, Hui AC. An electromyographic exploratory study comparing the difference in the onset of hamstring and quadriceps contraction in patients with anterior knee pain. The Knee. 2011;18(5):329-32. ##
  13. Cavazzuti L, Merlo A, Orlandi F, Campanini I. Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome. Gait & posture. 2010;32(3):290-5. ##
  14. Coqueiro KR, Bevilaqua-Grossi D, Bérzin F, Soares AB, Candolo C, Monteiro-Pedro V. Analysis on the activation of the VMO and VLL muscles during semisquat exercises with and without hip adduction in individuals with patellofemoral pain syndrome. Journal of Electromyography and Kinesiology. 2005;15(6):596-603. ##
  15. Herrington L, Pearson S. Does level of load affect relative activation levels of vastus medialis oblique and vastus laterialis?. Journal of Electromyography and Kinesiology. 2006;16(4):379-83. ##
  16.  Pal S, Besier TF, Draper CE, Fredericson M, Gold GE, Beaupre GS, Delp SL. Patellar tilt correlates with vastus lateralis: vastus medialis activation ratio in maltracking patellofemoral pain patients. Journal of Orthopaedic Research. 2012;30(6):927-33. ##
  17. Wong YM, Ng G. Resistance training alters the sensorimotor control of vasti muscles. Journal of Electromyography and Kinesiology. 2010;20(1):180-4. ##
  18. Toumi H, Best TM, Pinti A, Lavet C, Benhamou CL, Lespessailles E. The role of muscle strength & activation patterns in patellofemoral pain. Clinical Biomechanics. 2013;28(5):544-8. ##
  19. Felicio LR, Baffa AD, Liporacci RF, Saad MC, De Oliveira AS, Bevilaqua-Grossi D. Analysis of patellar stabilizers muscles and patellar kinematics in anterior knee pain subjects. Journal of Electromyography and Kinesiology. 2011;21(1):148-53. ##
  20. Santos EP, Bessa SN, Lins CA, Marinho AM, Silva KM, Brasileiro JS. Electromyographic activity of vastus medialis obliquus and vastus lateralis muscles during functional activities in subjects with patellofemoral pain syndrome. Brazilian Journal of Physical Therapy. 2008;12(4):304-10. ##
  21. Aminaka N, Pietrosimone BG, Armstrong CW, Meszaros A, Gribble PA. Patellofemoral pain syndrome alters neuromuscular control and kinetics during stair ambulation. Journal of Electromyography and Kinesiology. 2011;21(4):645-51##
  22. Liebensteiner MC, Szubski C, Raschner C, Krismer M, Burtscher M, Platzer HP, Deibl M, Dirnberger E. Frontal plane leg alignment and muscular activity during maximum eccentric contractions in individuals with and without patellofemoral pain syndrome. The Knee. 2008;15(3):180-6. ##
Volume 4, Issue 4 - Serial Number 4
November and December 2015
Pages 166-172
  • Receive Date: 08 March 2015
  • Revise Date: 20 June 2015
  • Accept Date: 20 July 2015
  • First Publish Date: 22 December 2015