INTRODUCTION Treatment options for adolescent patellofemoral pain (PFP) are limited. School footwear might be a suitable intervention to modulate patellofemoral joint (PFJ) loads in adolescents with PFP. This study examined the immediate effects of a flat, flexible school shoe compared to a traditional school shoe on knee joint kinematics and kinetics, and PFJ reaction force during walking and running in adolescents with PFP. METHODS 28 adolescents (12 female, 16 male, mean ± standard deviation age 14.3 ± 1.7 years) with PFP walked and ran on an instrumented treadmill in two randomly ordered conditions: (i) flat, flexible school shoe and (ii) traditional school shoe. Three-dimensional marker trajectory and ground reaction force data were sampled at 250 and 1000 Hz, respectively. Continuous ankle and knee joint angles and moments, PFJ reaction force and ankle power were compared between conditions using one-dimensional statistical parametric mapping paired t-tests (alpha <0.05). RESULTS Walking in the flat, flexible school shoe resulted in a significant reduction in knee flexion (15-35% of gait cycle, p < 0.001), knee extension moment (15-40% of gait cycle, p < 0.001) and PFJ reaction force (15-40% of gait cycle, p < 0.001) compared to the traditional school shoe. During running, knee flexion (10-33% of gait cycle, p < 0.001), knee extension moment (15-25% of gait cycle, p < 0.001) and PFJ reaction force (15-25% of gait cycle, p < 0.001) were lower when wearing the flat, flexible school shoe compared to the traditional school shoe. CONCLUSIONS PFJ reaction force is reduced when adolescents walk and run in a flat, flexible school shoe compared to a traditional school shoe. Flat, flexible school shoes may be an effective intervention to modulate biomechanical factors related to PFP.

中文翻译：

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扁平、灵活的校鞋对患有髌股疼痛的青少年的直接生物力学影响。

简介 青少年髌股疼痛 (PFP​​) 的治疗选择有限。学校鞋可能是调节 PFP 青少年髌股关节 (PFJ) 负荷的合适干预措施。本研究探讨了与传统学生鞋相比，扁平、灵活的学生鞋对 PFP 青少年步行和跑步时膝关节运动学和动力学以及 PFJ 反作用力的直接影响。方法 28 名患有 PFP 的青少年（12 名女性，16 名男性，平均±标准差年龄 14.3±1.7 岁）在两种随机排列的条件下在仪器跑步机上行走和跑步：(i) 平坦、灵活的校鞋和 (ii) 传统的校鞋。三维标记轨迹和地面反作用力数据分别以 250 和 1000 Hz 采样。使用一维统计参数映射配对 t 检验（α <0.05）比较不同条件下的连续踝关节和膝关节角度和力矩、PFJ 反作用力和踝关节功率。结果 穿着扁平、灵活的校鞋行走可显着减少膝关节屈曲（步态周期的 15-35%，p < 0.001）、膝关节伸展力矩（步态周期的 15-40%，p < 0.001）和 PFJ 反应与传统学校鞋相比，力（步态周期的 15-40%，p < 0.001）。跑步期间，膝关节屈曲（步态周期的 10-33%，p < 0.001）、膝关节伸展力矩（步态周期的 15-25%，p < 0.001）和 PFJ 反作用力（步态周期的 15-25%，p < 0.001） 0.001) 与穿着传统的学生鞋相比，穿着扁平、灵活的学生鞋时的值较低。结论 与传统的学校鞋相比，当青少年穿着扁平、灵活的学校鞋行走和跑步时，PFJ 反作用力会降低。扁平、灵活的校鞋可能是调节与 PFP 相关的生物力学因素的有效干预措施。