Motor Control of the Vastus Medialis Oblique and Vastus Lateralis Muscles is Disrupted during Eccentric Contractions in Subjects with Patellofemoral Pain

Abstract

Background Inappropriate control of the vastus medialis oblique and vastus lateralis muscles by the central nervous system can contribute to maltracking of the patella. Hypothesis The activation timing and amplitude of the vastus medialis oblique and vastus lateralis muscles will be different between normal subjects and patients with patellofemoral pain. Study Design Controlled laboratory study. Methods Subjects with patellofemoral pain and asymptomatic control subjects performed maximum voluntary knee extension contractions initiated from a flexed and an extended position. The activation timing and amplitude of the vastus lateralis and vastus medialis oblique muscles were quantified from the recorded electromyographic signals. Results There were no between-group differences in activation timing. The activation amplitude of the vastus medialis oblique and vastus lateralis muscles of the patellofemoral pain subjects was altered to the greatest extent during eccentric contractions and differed significantly from that of control subjects. Conclusions The activation amplitudes of the vastus medialis oblique and vastus lateralis muscles of subjects with patellofemoral pain are consistent with a laterally tracking patella during eccentric contractions. Clinical Relevance The findings suggest the clinical importance of determining whether altered activation patterns are sensitive to rehabilitation, and, if so, if subjective reports of knee joint pain and function parallel changes in the activation patterns as a result of rehabilitation.