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Risk Factors for Patellofemoral Pain in the Military: Systematic Review With Meta-Analysis.
Emannuel Alcides Bezerra Rocha1, Sanderson Josć Costa de Assis2, Dean Felipe Maciel Maia3
1Postgraduate Program in Rehabilitation Sciences, School of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, RN, Brazil; Postgraduate Programs in.
Journal of Athletic Training
|July 15, 2024
Summary
Military training attrition is often caused by knee injuries like patellofemoral pain (PFP). Weak knee-extensor strength and a larger frontal-plane knee angle are identified risk factors for PFP in military personnel.
Area of Science:
- Sports Medicine
- Military Health
- Biomechanics
Background:
- Musculoskeletal injuries, particularly patellofemoral pain (PFP), are a primary cause of attrition in military training.
- Identifying risk factors for PFP is crucial for developing effective injury prevention strategies in military populations.
Purpose of the Study:
- To systematically review and meta-analyze existing literature to identify factors that increase the risk of PFP occurrence in military personnel.
- To provide evidence-based insights for targeted injury prevention interventions.
Main Methods:
- Systematic review and meta-analysis of prospective cohort studies.
- Searches conducted across multiple major scientific databases (MEDLINE/PubMed, CINAHL, Embase, SPORTDiscus, Web of Science, Scopus, OpenGray).
- Data extracted by two independent evaluators, comparing individuals who developed PFP with those who did not.
Main Results:
- Analysis of 11 articles involving 7518 military personnel, with 572 (7.61%) developing PFP.
- Moderate evidence indicates isokinetic knee-extensor weakness at 60°/s predicts PFP (SMD = -0.69).
- Moderate evidence identifies a larger frontal-plane knee-projection angle during single-legged squat as a risk factor in males (SMD = 0.55).
- Moderate evidence suggests sex, BMI, and isometric/isokinetic knee-flexor strength do not predict PFP; strong evidence indicates age and body mass do not predict PFP.
Conclusions:
- Deficits in isokinetic knee-extensor strength and increased frontal-plane knee-projection angle are significant risk factors for PFP in military personnel.
- These identified risk factors are modifiable, highlighting their importance for developing targeted injury-prevention programs.
- Interventions focusing on improving knee-extensor strength and controlling frontal-plane knee motion may reduce PFP incidence in the military.
