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A Study of Lateral Step-Down Test Performance in Those With Chronic Unilateral Patellofemoral Pain: Frontal Plane Movement of the Knee, Reliability, Timing, and Fear of Movement /

Record Type:	Electronic resources : Monograph/item
Title/Author:	A Study of Lateral Step-Down Test Performance in Those With Chronic Unilateral Patellofemoral Pain: Frontal Plane Movement of the Knee, Reliability, Timing, and Fear of Movement // Cody James Mansfield.
Author:	Mansfield, Cody James,
Description:	1 electronic resource (208 pages)
Notes:	Source: Dissertations Abstracts International, Volume: 86-11, Section: B.
Contained By:	Dissertations Abstracts International86-11B.
Subject:	Kinesiology. -
Online resource:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=32111840
ISBN:	9798314889817

A Study of Lateral Step-Down Test Performance in Those With Chronic Unilateral Patellofemoral Pain: Frontal Plane Movement of the Knee, Reliability, Timing, and Fear of Movement /
Mansfield, Cody James,

A Study of Lateral Step-Down Test Performance in Those With Chronic Unilateral Patellofemoral Pain: Frontal Plane Movement of the Knee, Reliability, Timing, and Fear of Movement /Cody James Mansfield. - 1 electronic resource (208 pages)

Source: Dissertations Abstracts International, Volume: 86-11, Section: B.

Purpose: Patellofemoral pain (PFP) is a prevalent condition with high recurrence that limits mobility and reduces quality of life. The lateral step-down test (LSDT)is used to assess lower extremity movement quality in individuals with PFP with an emphasis on frontal plane movement. Knee valgus, the frontal plane movement of the knee medially, during weight bearing lower extremity tasks increases patellofemoral joint forces. Rehabilitation professionals appraise movement quality with the goal of reducing knee valgus during activity to reduce patellofemoral joint forces and pain. It is unclear if experienced and novice physical therapists can measure movement quality by identifying the same number of movement deviations and measure knee valgus between each other. Alterations in movement occur in individuals with PFP with various step-down and single leg squat tasks. Understanding how fear of movement, as measured by the Tampa Scale of Kinesiophobia (TSK-17), and PFP, may relate to movement is a research priority in the field. The relationship of the TSK-17 and the frontal plane projection angle (FPPA), a 2-dimensional (2D) measure of knee valgus, during the LSDT remains relatively unexplored. Also, the temporal demands of the LSDT are unknown. The primary purpose of this dissertation was to 1) Examine if there is a difference between expert and novice physical therapists appraising quality movement and establish the reliability of physical therapists measuring the 2D measurement of the FPPA of individuals with chronic PFP during LSDT, 2) Investigate the relationship of kinesiophobia as measured by the TSK-17 on the average FPPA when measured at the lowest point of descent during the LSDT while controlling for key covariates, and 3) Explore the interlimb temporal performance of individuals with unilateral PFP during the different phases of the LSDT, and overall time to complete the test.Methods: This dissertation used baseline data from an ongoing registered randomized controlled trial analyzing the effects of physical therapy and dry needling on PFP, patient reported outcome measures, movement, and strength. The dissertation work included the following methodologies: 1. To determine the inter and intra rater reliability of physical therapists measuring movement quality using the appraisal categories, three experienced and three novice physical therapists appraised the movement quality of 22 individuals with PFP at baseline, and the same videos one week later. Then differences between the groups (experienced verses novices) were assessed with a chi-square test.2. Interrater reliability of six physical therapists measuring the FPPA of 22 individuals with PFP during the LSDT using 2D video software was determined using intraclass correlation. 3. The relationship of kinesiophobia (TSK-17) on FPPA during performance of the LSDT was investigated in 87 participants with PFP. Linear regression was used to examine the relationship between TSK-17 score and the average peak FPPA at the lowest point of descent across five repetitions of the LSDT on just the involved PFP leg, controlling for height, pain during the task, and isometric hip abduction strength. 4. Interlimb temporal performance during the LSDT was investigated in 52 participants with PFP as a subset analysis. Temporal performance across the three phases of the LSDT (descent, transition, and ascent) was captured using 2D video analysis, and summed together for the overall completion time. Two repeated measures general linear models were used to compare temporal performance between the involved and contralateral legs across LSDT phases and overall time to complete the LSDT, controlling for height, fear of movement, and hip abduction strength.Results: 1. Inter- and intra-rater reliability of quality of movement assessment by physical therapists ranged from fair to moderate (?=0.40-0.65). There was no significant difference between experienced and novice physical therapists (p>0.05) appraising movement quality. 2. Reliability of six physical therapists measuring the FPPA was good (ICC [95% CI]=0.85[0.72-0.93].3. There was no significant association between kinesiophobia and the FPPA when measured at the lowest point of descent during the LSDT (p>0.05), while controlling for key covariates. 4. There was no significant difference in temporal performance between the involved PFP leg and contralateral legs across any of the LSDT phases (p>0.05), and overall time to complete the LSDT (p>0.05), but a significant difference in time to perform each phase for both the PFP leg and contralateral leg with the descent phase taking the longest (p<0.01). Conclusions: Evaluation of quality of movement using a rubric during the LSDT demonstrated fair-to-moderate inter-rater and intra-rater reliability. There was no difference between experienced and novice physical therapists using a movement rubric to appraise quality of movement of individuals with PFP. Measurement of the peak FPPA during task descent amongst physical therapists demonstrated good reliability at a single time point. Kinesiophobia was not significantly associated with frontal plane knee movement during the descent phase of the LSDT, when considering relevant covariates. Individuals with PFP did not exhibit significant interlimb temporal differences when performing the LSDT when controlling for relevant covariates. Phase specific demands may be important, as the descent phase took the most time to complete. This research provides novel insights into the LSDT, demonstrating no difference between physical therapist experience levels in quality of movement assessment, no association between kinesiophobia and frontal plane knee motion, phase specific differences during the LSDT, and no temporal differences between limbs.

English

ISBN: 9798314889817Subjects--Topical Terms:

517627
Kinesiology.
Subjects--Index Terms:

Patellofemoral pain

A Study of Lateral Step-Down Test Performance in Those With Chronic Unilateral Patellofemoral Pain: Frontal Plane Movement of the Knee, Reliability, Timing, and Fear of Movement /
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520 $a Purpose: Patellofemoral pain (PFP) is a prevalent condition with high recurrence that limits mobility and reduces quality of life. The lateral step-down test (LSDT)is used to assess lower extremity movement quality in individuals with PFP with an emphasis on frontal plane movement. Knee valgus, the frontal plane movement of the knee medially, during weight bearing lower extremity tasks increases patellofemoral joint forces. Rehabilitation professionals appraise movement quality with the goal of reducing knee valgus during activity to reduce patellofemoral joint forces and pain. It is unclear if experienced and novice physical therapists can measure movement quality by identifying the same number of movement deviations and measure knee valgus between each other. Alterations in movement occur in individuals with PFP with various step-down and single leg squat tasks. Understanding how fear of movement, as measured by the Tampa Scale of Kinesiophobia (TSK-17), and PFP, may relate to movement is a research priority in the field. The relationship of the TSK-17 and the frontal plane projection angle (FPPA), a 2-dimensional (2D) measure of knee valgus, during the LSDT remains relatively unexplored. Also, the temporal demands of the LSDT are unknown. The primary purpose of this dissertation was to 1) Examine if there is a difference between expert and novice physical therapists appraising quality movement and establish the reliability of physical therapists measuring the 2D measurement of the FPPA of individuals with chronic PFP during LSDT, 2) Investigate the relationship of kinesiophobia as measured by the TSK-17 on the average FPPA when measured at the lowest point of descent during the LSDT while controlling for key covariates, and 3) Explore the interlimb temporal performance of individuals with unilateral PFP during the different phases of the LSDT, and overall time to complete the test.Methods: This dissertation used baseline data from an ongoing registered randomized controlled trial analyzing the effects of physical therapy and dry needling on PFP, patient reported outcome measures, movement, and strength. The dissertation work included the following methodologies: 1. To determine the inter and intra rater reliability of physical therapists measuring movement quality using the appraisal categories, three experienced and three novice physical therapists appraised the movement quality of 22 individuals with PFP at baseline, and the same videos one week later. Then differences between the groups (experienced verses novices) were assessed with a chi-square test.2. Interrater reliability of six physical therapists measuring the FPPA of 22 individuals with PFP during the LSDT using 2D video software was determined using intraclass correlation. 3. The relationship of kinesiophobia (TSK-17) on FPPA during performance of the LSDT was investigated in 87 participants with PFP. Linear regression was used to examine the relationship between TSK-17 score and the average peak FPPA at the lowest point of descent across five repetitions of the LSDT on just the involved PFP leg, controlling for height, pain during the task, and isometric hip abduction strength. 4. Interlimb temporal performance during the LSDT was investigated in 52 participants with PFP as a subset analysis. Temporal performance across the three phases of the LSDT (descent, transition, and ascent) was captured using 2D video analysis, and summed together for the overall completion time. Two repeated measures general linear models were used to compare temporal performance between the involved and contralateral legs across LSDT phases and overall time to complete the LSDT, controlling for height, fear of movement, and hip abduction strength.Results: 1. Inter- and intra-rater reliability of quality of movement assessment by physical therapists ranged from fair to moderate (?=0.40-0.65). There was no significant difference between experienced and novice physical therapists (p>0.05) appraising movement quality. 2. Reliability of six physical therapists measuring the FPPA was good (ICC [95% CI]=0.85[0.72-0.93].3. There was no significant association between kinesiophobia and the FPPA when measured at the lowest point of descent during the LSDT (p>0.05), while controlling for key covariates. 4. There was no significant difference in temporal performance between the involved PFP leg and contralateral legs across any of the LSDT phases (p>0.05), and overall time to complete the LSDT (p>0.05), but a significant difference in time to perform each phase for both the PFP leg and contralateral leg with the descent phase taking the longest (p<0.01). Conclusions: Evaluation of quality of movement using a rubric during the LSDT demonstrated fair-to-moderate inter-rater and intra-rater reliability. There was no difference between experienced and novice physical therapists using a movement rubric to appraise quality of movement of individuals with PFP. Measurement of the peak FPPA during task descent amongst physical therapists demonstrated good reliability at a single time point. Kinesiophobia was not significantly associated with frontal plane knee movement during the descent phase of the LSDT, when considering relevant covariates. Individuals with PFP did not exhibit significant interlimb temporal differences when performing the LSDT when controlling for relevant covariates. Phase specific demands may be important, as the descent phase took the most time to complete. This research provides novel insights into the LSDT, demonstrating no difference between physical therapist experience levels in quality of movement assessment, no association between kinesiophobia and frontal plane knee motion, phase specific differences during the LSDT, and no temporal differences between limbs.
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