How do gait characteristics vary across mild, moderate, and severe pain levels in women with patellofemoral pain?

Authors:
  • FSFelipe Reis de Souza
    Felipe Reis de Souza
  • GNGabriel J. Navarro
    Gabriel J. Navarro
  • OLOtavio H.C Leite
    Otavio H.C Leite
  • NRNara Lourdes Moreno Rodrigues
    Nara Lourdes Moreno Rodrigues
  • ISIcaro Alef Coelho dos Santos
    Icaro Alef Coelho dos Santos
  • GBGábor József Barton
    Gábor József Barton
Preprint
Publisher website
Google Scholar
Abstract
Patellofemoral pain (PFP) is associated with altered gait, but it remains unclear whether women with different pain levels present distinct movement characteristics and whether pain intensity relates to the magnitude of gait deviation. To examine whether gait deviation and gait characteristics differ across mild, moderate, and severe pain levels in women with PFP, and to determine whether pain intensity is associated with overall gait deviation. A retrospective cross-sectional study was conducted with 237 women with PFP, categorized into mild, moderate, and severe pain groups. Three-dimensional gait kinematics and spatiotemporal parameters were collected during ground walking. Gait deviation was quantified using the Movement Deviation Profile (MDP), a summary index of kinematic deviation. Group differences and the association between pain intensity and MDP were assessed using non-parametric analyses. Continuous kinematic waveforms were evaluated using Statistical Parametric Mapping. Higher pain levels were associated with greater gait deviation, and pain intensity was strongly positively associated with MDP. Women with higher pain walked more slowly and with shorter steps. Kinematic analyses identified distinct patterns across groups: moderate pain was characterized by altered pelvic and hip control in the frontal plane, while severe pain showed additional differences at the ankle and in foot progression, including a progressively more externally rotated foot throughout the gait cycle. Pain severity in PFP correlates with notable differences in gait deviation and specific movement patterns. Considering pain severity levels may enhance clinical interpretation of gait in PFP and facilitate more personalised rehabilitation strategies.