Mechanical elements related to the development of patellofemoral pain syndrome, pain intensity, and functional disability: A cross-sectional study
- 1Virginia Commonwealth University
Abstract
Background and purposePatellofemoral pain syndrome (PFPS) is a multifaceted condition where proximal, local, and distal factors may contribute to symptoms and limitations. How these factors collectively contribute to PFPS remains poorly understood. Therefore, this study compared proximal, local, and distal mechanical characteristics between individuals with and without PFPS and investigated their association with pain intensity and functional disability.
MethodsEighty participants were included: 40 individuals with unilateral or bilateral PFPS, 40 healthy controls. Isometric muscle strength of hip, trunk, and ankle was assessed using a hand-held dynamometer. Joint alignment (Q-angle, rearfoot angle, pelvic tilt) and muscle flexibility (iliotibial band, hamstrings, quadriceps, gastrocnemius, and soleus) were measured using standard clinical techniques. Pain severity was assessed using a visual analog scale (VAS), and functional disability was evaluated using the Kujala score.
ResultsIndividuals with PFPS showed reduced iliotibial band flexibility, decreased hamstring and soleus length, lower hip abductor strength, and greater anterior and lateral pelvic tilt (all p [≤] 0.02). Multivariate analysis identified reduced iliotibial band flexibility (OR = 7.48) and greater anterior pelvic tilt (OR = 11.75) as independent associates of PFPS. Anterior pelvic tilt predicted pain severity, while anterior trunk muscle strength and Q-angle predicted disability.
DiscussionReduced iliotibial band flexibility and increased anterior pelvic tilt were independently associated with PFPS, while anterior pelvic tilt predicted pain severity and anterior trunk muscle strength and Q-angle predicted functional disability. Clinical assessment and rehabilitation of PFPS should therefore extend beyond the knee to include iliotibial band flexibility, pelvic alignment, and trunk muscle strength.
Related
- Development of mechanically optimized biomimetic hybrid scaffold–stem cell constructs for functional tendon regeneration and restoration of mechanical integrity
- Beyond the Rankin Scale: A Patient‐Centered Score for Meaningful Recovery After Mechanical Thrombectomy in Older Adults With Pre‐Stroke Disability
- Clinical and functional outcomes of aquatic plyometrics in adolescent patellofemoral pain syndrome: a dual-arm randomized controlled trial.
- The Epidemiology of Disability in Saudi Arabia: National Prevalence, Functional Multimorbidity, and Age-Stratified Self-Reported Causes
- Depression, functional disability, and cardiovascular disease in adults with cardiovascular-kidney-metabolic syndrome stages 0–3: a nationally representative cohort study
BibTeX
@misc{yaghoubi2026mechanical,
title = {{Mechanical elements related to the development of patellofemoral pain syndrome, pain intensity, and functional disability: A cross-sectional study}},
author = {N. Yaghoubi and M. Eghbali and M. Soleimanifar and F. Hashemirad and A. Arab},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.26.26361453},
url = {https://www.medrxiv.org/content/10.64898/2026.08.26.26361453v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Mechanical elements related to the development of patellofemoral pain syndrome, pain intensity, and functional disability: A cross-sectional study
AU - N. Yaghoubi
AU - M. Eghbali
AU - M. Soleimanifar
AU - F. Hashemirad
AU - A. Arab
PY - 2026
DA - 2026/08/26
PB - medRxiv
DO - 10.64898/2026.08.26.26361453
UR - https://www.medrxiv.org/content/10.64898/2026.08.26.26361453v1
AB - Background and purposePatellofemoral pain syndrome (PFPS) is a multifaceted condition where proximal, local, and distal factors may contribute to symptoms and limitations. How these factors collectively contribute to PFPS remains poorly understood. Therefore, this study compared proximal, local, and distal mechanical characteristics between individuals with and without PFPS and investigated their association with pain intensity and functional disability. MethodsEighty participants were included: 40 individuals with unilateral or bilateral PFPS, 40 healthy controls. Isometric muscle strength of hip, trunk, and ankle was assessed using a hand-held dynamometer. Joint alignment (Q-angle, rearfoot angle, pelvic tilt) and muscle flexibility (iliotibial band, hamstrings, quadriceps, gastrocnemius, and soleus) were measured using standard clinical techniques. Pain severity was assessed using a visual analog scale (VAS), and functional disability was evaluated using the Kujala score. ResultsIndividuals with PFPS showed reduced iliotibial band flexibility, decreased hamstring and soleus length, lower hip abductor strength, and greater anterior and lateral pelvic tilt (all p [≤] 0.02). Multivariate analysis identified reduced iliotibial band flexibility (OR = 7.48) and greater anterior pelvic tilt (OR = 11.75) as independent associates of PFPS. Anterior pelvic tilt predicted pain severity, while anterior trunk muscle strength and Q-angle predicted disability. DiscussionReduced iliotibial band flexibility and increased anterior pelvic tilt were independently associated with PFPS, while anterior pelvic tilt predicted pain severity and anterior trunk muscle strength and Q-angle predicted functional disability. Clinical assessment and rehabilitation of PFPS should therefore extend beyond the knee to include iliotibial band flexibility, pelvic alignment, and trunk muscle strength.
ER -