Como as características da marcha variam entre mulheres com dor femoropatelar em níveis leve, moderado e severo?

Abstract

Introduction: 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. Objective: To examine whether gait deviation and gait characteristics differ across different pain levels in women with PFP, and to determine whether pain intensity is associated with overall gait deviation. Methods: 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 (237 healthy controls). Group differences and the association between pain intensity and MDP were assessed using non-parametric analyses. Continuous kinematic waveforms were evaluated using Statistical non-Parametric Mapping (SnPM). Results: 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 characterised 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. Conclusion: Women with different levels of DFP showed differences in MDP. Pain intensity 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.