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The variables analyzed were trunk and lower limb joint angles. Self-organizing maps and K-means clustering techniques were used to identify distinct biokinetic profiles. Clinical characteristics compared among profiles were hip\/knee isometric strength and passive range of motion, descriptive characteristics, and patient-reported outcome measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Four biokinetic profiles were identified for the step-down task in patients with PFP. Profile 1 (Balanced Alignment Profile) exhibited a trunk-hip-knee aligned movement pattern, with increased knee flexion (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05). This profile presented the highest International Knee Documentation Committee (IKDC) Subjective Form and the lowest visual analog scale (VAS)-Pain scores (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05). Profile 2 (Trunk-hip-knee Compensation Profile) and Profile 3 (Pelvic-Hip Interactor Profile) exhibited increased dynamic knee valgus during the step-down task. However, Profile 2 presented limited trunk (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05) and knee flexion, while Profile 3 presented increased anterior pelvic tilt (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05) and trunk flexion. Profile 2 had excessive passive hip internal rotation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05) and a majority of women (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05), while Profile 3 exhibited increased isometric hip and knee strength (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05) and lower levels of pain. Profile 4 (Protective Movement Profile) exhibited a possibly protective adaptation, showing decreased hip, knee, and pelvis peak angles and decreased ipsilateral trunk tilt (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05), as well as the lowest IKDC scores and the highest VAS-Pain scores (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study identified 4 clinically relevant biokinetic profiles of patients with PFP based on their kinematics during a step-down task. The principal clinical value of this study is the development of a functional classification for patients with PFP. Each profile exhibits characteristics that may provide valuable insights for clinicians to implement targeted interventions and improve patient care. Acknowledging the variability in movement profiles and their implications in PFP underscores the importance of moving beyond one-size-fits-all treatment strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>This study uncovers previously unknown movement-based biokinetic profiles in patellofemoral pain and identifies several modifiable clinical characteristics associated with each profile, which could be addressed through targeted interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671251371238","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T09:39:58Z","timestamp":1758015598000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Biokinetic Profiles in Patellofemoral Pain Patients During a Step-Down Task: An Unsupervised Machine Learning Approach"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9263-1309","authenticated-orcid":false,"given":"Leonardo","family":"Metsavaht","sequence":"first","affiliation":[{"name":"Departamento de Diagn\u00f3stico por Imagem, Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo, State of S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7265-4658","authenticated-orcid":false,"given":"Gustavo","family":"Leporace","sequence":"additional","affiliation":[{"name":"Department of Biomechanics, Instituto Brasil de Tecnologias da Sa\u00fade, Ipanema, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7142-6031","authenticated-orcid":false,"given":"Felipe F.","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Biomechanics, Instituto Brasil de Tecnologias da Sa\u00fade, Ipanema, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3250-4134","authenticated-orcid":false,"given":"Eliane C.","family":"Guadagnin","sequence":"additional","affiliation":[{"name":"Department of Biomechanics, Instituto Brasil de Tecnologias da Sa\u00fade, Ipanema, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9642-4868","authenticated-orcid":false,"given":"Enzo","family":"Mameri","sequence":"additional","affiliation":[{"name":"Departamento de Diagn\u00f3stico por Imagem, Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo, State of S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan A.","family":"Gustafson","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9601-4217","authenticated-orcid":false,"given":"Adam","family":"Yanke","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Chahla","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Luzo","sequence":"additional","affiliation":[{"name":"Departamento de Diagn\u00f3stico por Imagem, Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo, State of S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.humov.2020.102649"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1519\/JSC.0000000000004128"},{"issue":"4","key":"e_1_3_2_4_2","first-page":"298","article-title":"The effect of patellofemoral pain syndrome on gait parameters: a literature review","volume":"4","author":"Arazpour M","year":"2016","unstructured":"Arazpour M, Bahramian F, Abutorabi A, Nourbakhsh ST, Alidousti A, Aslani H. 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