| Title: |
Biokinetic Profiles in Patellofemoral Pain Patients During a Step-Down Task: An Unsupervised Machine Learning Approach |
| Authors: |
Metsavaht, Leonardo; Leporace, Gustavo; Gonzalez, Felipe F.; Guadagnin, Eliane C.; Mameri, Enzo; Gustafson, Jonathan A.; Yanke, Adam; Chahla, Jorge; Luzo, Marcus |
| Contributors: |
universidade federal de são paulo |
| Source: |
Orthopaedic Journal of Sports Medicine ; volume 13, issue 9 ; ISSN 2325-9671 2325-9671 |
| Publisher Information: |
SAGE Publications |
| Publication Year: |
2025 |
| Description: |
Background: There is a lack of consensus regarding the optimal identification of motion-based subgroups (biokinetic profiles) of patients with patellofemoral pain (PFP) to guide effective management strategies. Purpose: To investigate different biokinetic profiles among patients with PFP during a step-down task and compare their clinical and physical characteristics. Study Design: Descriptive laboratory study. Methods: A total of 49 patients with PFP had their 3-dimensional kinematics assessed during a step-down task using an optoelectronic system. The variables analyzed were trunk and lower limb joint angles. Self-organizing maps and K-means clustering techniques were used to identify distinct biokinetic profiles. Clinical characteristics compared among profiles were hip/knee isometric strength and passive range of motion, descriptive characteristics, and patient-reported outcome measures. Results: Four biokinetic profiles were identified for the step-down task in patients with PFP. Profile 1 (Balanced Alignment Profile) exhibited a trunk-hip-knee aligned movement pattern, with increased knee flexion ( P < .05). This profile presented the highest International Knee Documentation Committee (IKDC) Subjective Form and the lowest visual analog scale (VAS)-Pain scores ( P < .05). Profile 2 (Trunk-hip-knee Compensation Profile) and Profile 3 (Pelvic-Hip Interactor Profile) exhibited increased dynamic knee valgus during the step-down task. However, Profile 2 presented limited trunk ( P < .05) and knee flexion, while Profile 3 presented increased anterior pelvic tilt ( P < .05) and trunk flexion. Profile 2 had excessive passive hip internal rotation ( P < .05) and a majority of women ( P < .05), while Profile 3 exhibited increased isometric hip and knee strength ( P < .05) and lower levels of pain. Profile 4 (Protective Movement Profile) exhibited a possibly protective adaptation, showing decreased hip, knee, and pelvis peak angles and decreased ipsilateral trunk tilt ( P < .05), as well as the ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1177/23259671251371238 |
| Availability: |
https://doi.org/10.1177/23259671251371238; https://journals.sagepub.com/doi/pdf/10.1177/23259671251371238; https://journals.sagepub.com/doi/full-xml/10.1177/23259671251371238 |
| Rights: |
https://creativecommons.org/licenses/by-nc-nd/4.0/ ; https://journals.sagepub.com/page/policies/text-and-data-mining-license |
| Accession Number: |
edsbas.64E9BE17 |
| Database: |
BASE |