Effects of three gait retraining techniques in runners with patellofemoral pain

Phys Ther Sport. 2019 Mar;36:92-100. doi: 10.1016/j.ptsp.2019.01.006. Epub 2019 Jan 18.


Objectives: Analyze the effects of 3 gait retraining: forefoot landing (FFOOT), 10% step rate increase (SR10%) and forward trunk lean (FTL) on lower limb biomechanics and clinical measurements in patellofemoral pain (PFP) runners.

Design: Case series report.

Settings: Biomechanical laboratory and treadmill running.

Participants: Eighteen recreational PFP runners randomized in 3 groups.

Main outcome measures: Lower limb kinematics and muscle activation were assessed at baseline and 2-week post-training. Pain intensity and function limitation, measured by AKPS (Anterior Knee Pain Scale) and LEFS (Lower Extremity Functional Scale) assessed at baseline, post-training and 6-month follow-up. Repeated measures analysis of variance was used to compare the effects of gait retraining.

Results: FFOOT and FTL increased the AKPS score at post-training(P = .001; P = .008) and 6-month follow-up(P < .001; P < .001). SR10% increased the AKPS score from baseline to 6-month follow-up(P = .006). Pain and LEFS score were improved after gait retraining regardless group. FFOOT presented greater gastrocnemius(P = .037) and rectus femoris pre-activation(P = .006) at post-retraining session. Gait retraining reduced the muscle activity during stance phase and increased during the late-swing regardless group.

Conclusion: The three techniques presented clinical benefits, improvement of pain symptoms and functional scores, was not accompanied with significant biomechanics differences that could entirely explain this clinical improvement after the intervention.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Biomechanical Phenomena / physiology
  • Exercise Therapy / methods*
  • Female
  • Gait / physiology*
  • Humans
  • Lower Extremity / physiology
  • Male
  • Pain Measurement
  • Patellofemoral Pain Syndrome / physiopathology
  • Patellofemoral Pain Syndrome / rehabilitation*
  • Running / physiology