Paulo Roberto Garcia Lucareli

Temporomandibular disorder (TMD) is a multifactorial condition characterized by a range of signs and symptoms, including pain, tinnitus, occlusal alterations, joint sounds, and headaches, which pri...

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.

Anatomic and functional changes in the pelvic floor muscles (PFMs) have been associated with stress urinary incontinence (SUI). The aim of this study is to compare cough-induced contraction response time and PFM strength in women with and without SUI. This cross-sectional study evaluated 40 women (20 with and 20 without SUI) aged 20 to 60 years. PFM strength was measured using a vaginal dynamometer. The cough signal was captured using an accelerometer, and activity of the right external oblique muscle was measured using surface electromyography. All signals were synchronized and recorded using the same signal acquisition module. Analysis of covariance (ANCOVA) with the Bonferroni post hoc test was used to compare the dynamometric data between groups (control and SUI). No significant differences were found between groups regarding variables related to PFM strength, but significant differences were found for activation time of the PFMs (F = 59.42, p < 0.0001, η_p² = 0.76), activation time of the external oblique muscle (F = 6.55, p = 0.004, η_p² = 0.26), and cough pulse time (F = 3.32, p = 0.04, η_p² = 0.15). Women with stress urinary have a delayed cough-induced contraction response of the pelvic floor muscles, but no difference in the contraction force of these muscles was found in comparison to women without stress urinary incontinence.