{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T03:38:58Z","timestamp":1785901138573,"version":"3.56.0"},"reference-count":28,"publisher":"National Athletic Trainers' Association","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>In the existing patellofemoral pain (PFP) literature, researchers often have assessed a single joint or each joint independently with limited evidence considering the relative contributions of the entire lower limb joint complex (ie, hip-knee-ankle).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare joint work and work contributions of the hip, knee, and ankle in the sagittal and frontal planes during a single-legged squat and lunge between women with PFP and pain-free women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Laboratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients or Other Participants<\/jats:title>\n                    <jats:p>A total of 34 women aged 18 to 40 years, including 17 participants with PFP (age = 26.1 \u00b1 5.4 years, height = 165.3 \u00b1 4.9 cm, mass = 66.2 \u00b1 14.7 kg) and 17 pain-free participants (age = 27.2 \u00b1 2.9 years, height = 162.7 \u00b1 4.4 cm, mass = 59.0 \u00b1 6.8 kg).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>\n                      Joint work was computed by integrating the negative (energy absorption) or positive (energy generation) regions of the joint power curve. Joint work contribution was determined as a percentage of the sum of all 3 lower limb joints (hip, knee, and ankle) during energy absorption and energy generation. Group comparisons were performed using independent\n                      <jats:italic>t<\/jats:italic>\n                      tests or Mann-Whitney\n                      <jats:italic>U<\/jats:italic>\n                      tests with Cohen\n                      <jats:italic>d<\/jats:italic>\n                      or Wilcoxon\n                      <jats:italic>r<\/jats:italic>\n                      effect sizes, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During the single-legged squat, women with PFP exhibited greater ankle-joint work (\n                      <jats:italic>P<\/jats:italic>\n                      \u2264 .04; Cohen\n                      <jats:italic>d<\/jats:italic>\n                      range, 0.74\u20130.87) and higher ankle-joint work contribution (\n                      <jats:italic>P<\/jats:italic>\n                      \u2264 .01; Cohen\n                      <jats:italic>d<\/jats:italic>\n                      = 0.91 or\n                      <jats:italic>r<\/jats:italic>\n                      = 0.48) in the sagittal plane for both energy absorption and generation compared with pain-free women. During the lunge, women with PFP displayed greater hip-, ankle-, and total joint work (\n                      <jats:italic>P<\/jats:italic>\n                      \u2264 .04;\n                      <jats:italic>r<\/jats:italic>\n                      range, 0.37\u20130.61) and higher hip-joint work contribution (\n                      <jats:italic>P<\/jats:italic>\n                      \u2264 .049; Cohen\n                      <jats:italic>d<\/jats:italic>\n                      range, 0.70\u20130.71) in the frontal plane for both energy absorption and generation compared with pain-free women.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Women with PFP may have different joint work redistribution strategies during functional tasks, characterized by increased work and work contributions from the proximal (hip) and distal (ankle) joints compared with pain-free women. Despite greater work by the proximal and distal joints, knee-joint work remained similar to that of pain-free women, resulting in a higher total work demand for the lower limb in women with PFP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4085\/1062-6050-0284.25","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T01:16:17Z","timestamp":1770858977000},"page":"454-464","source":"Crossref","is-referenced-by-count":1,"title":["Lower Limb Energetic Redistribution During Functional Tasks in Patellofemoral Pain: Proximal, Local, and Distal Contributions"],"prefix":"10.4085","volume":"61","author":[{"given":"Sungwan","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Sport Science, Pusan National University, Busan, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie P.","family":"Burland","sequence":"additional","affiliation":[{"name":"Department of Kinesiology,"},{"name":"Institute for Sports Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin D.","family":"Morgan","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, University of Connecticut, Storrs"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay J.","family":"DiStefano","sequence":"additional","affiliation":[{"name":"Department of Kinesiology,"},{"name":"Institute for Sports Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle C.","family":"Boling","sequence":"additional","affiliation":[{"name":"Department of Clinical and Applied Movement Sciences, University of North Florida, Jacksonville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal R.","family":"Glaviano","sequence":"additional","affiliation":[{"name":"Department of Kinesiology,"},{"name":"Institute for Sports Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","reference":[{"issue":"5","key":"i1938-162X-61-7-454-b01","series-title":"Scand J Med Sci Sports","first-page":"725","article-title":"Gender differences in the incidence and prevalence of patellofemoral pain syndrome","volume":"20","author":"Boling","year":"2010","unstructured":"Boling M,\nPadua D,\nMarshall S,\nGuskiewicz K,\nPyne S,\nBeutler A. Gender differences in the incidence and prevalence of patellofemoral pain syndrome. Scand J Med Sci Sports. 2010;20(5):725\u2013730. doi:10.1111\/j.1600-0838.2009.00996.x"},{"issue":"14","key":"i1938-162X-61-7-454-b02","series-title":"Br J Sports Med","first-page":"839","article-title":"2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester, part 1: terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures","volume":"50","author":"Crossley","year":"2016","unstructured":"Crossley KM,\nStefanik JJ,\nSelfe J, et al. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester, part 1: terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. Br J Sports Med. 2016;50(14):839\u2013843. doi:10.1136\/bjsports-2016-096384"},{"key":"i1938-162X-61-7-454-b03","series-title":"Musculoskelet Sci Pract","first-page":"102473","article-title":"Patient experience of the diagnosis and management of patellofemoral pain: a qualitative exploration","volume":"57","author":"Barber","year":"2022","unstructured":"Barber P,\nLack SD,\nBartholomew C, et al. Patient experience of the diagnosis and management of patellofemoral pain: a qualitative exploration. Musculoskelet Sci Pract. 2022;57:102473. doi:10.1016\/j.msksp.2021.102473"},{"key":"i1938-162X-61-7-454-b04","series-title":"Phys Ther Sport","first-page":"1","article-title":"Living well (or not) with patellofemoral pain: a qualitative study","volume":"56","author":"Glaviano","year":"2022","unstructured":"Glaviano NR,\nHolden S,\nBazett-Jones DM,\nSinge SM,\nRathleff MS. Living well (or not) with patellofemoral pain: a qualitative study. 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Patellofemoral pain: proximal, distal, and local factors, 2nd International Research Retreat. J Orthop Sports Phys Ther. 2012;42(6):A1\u2013A54. doi:10.2519\/jospt.2012.0301"},{"issue":"12","key":"i1938-162X-61-7-454-b07","series-title":"Sports Med","first-page":"1797","article-title":"Is there a biomechanical link between patellofemoral pain and osteoarthritis? A narrative review","volume":"46","author":"Wyndow","year":"2016","unstructured":"Wyndow N,\nCollins N,\nVicenzino B,\nTucker K,\nCrossley K. Is there a biomechanical link between patellofemoral pain and osteoarthritis? A narrative review. Sports Med. 2016;46(12):1797\u20131808. doi:10.1007\/s40279-016-0545-6"},{"key":"i1938-162X-61-7-454-b08","series-title":"Gait Posture","first-page":"94","article-title":"Single-leg horizontal jump is more suitable for assessing lower limb function compared to single-leg vertical jump in patellofemoral pain patients","volume":"115","author":"Pan","year":"2025","unstructured":"Pan H,\nFu S,\nZhou Y,\nLong T,\nLi H,\nShi H. Single-leg horizontal jump is more suitable for assessing lower limb function compared to single-leg vertical jump in patellofemoral pain patients. Gait Posture. 2025;115:94\u2013101. doi:10.1016\/j.gaitpost.2024.11.008"},{"key":"i1938-162X-61-7-454-b09","series-title":"Gait Posture","first-page":"164","article-title":"Do bilateral deficits in hop for distance performance occur concomitantly with bilateral movement differences in people with patellofemoral pain? 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Differences in gluteal and quadriceps muscle activation during weight-bearing exercises between female subjects with and without patellofemoral pain. J Strength Cond Res. 2022;36(1):55\u201362. doi:10.1519\/JSC.0000000000003392"},{"issue":"10","key":"i1938-162X-61-7-454-b16","series-title":"J Athl Train","first-page":"1011","article-title":"Joint kinetics and kinematics during common lower limb rehabilitation exercises","volume":"50","author":"Comfort","year":"2015","unstructured":"Comfort P,\nJones PA,\nSmith LC,\nHerrington L. Joint kinetics and kinematics during common lower limb rehabilitation exercises. J Athl Train. 2015;50(10):1011\u20131018. doi:10.4085\/1062-6050-50.9.05"},{"issue":"7","key":"i1938-162X-61-7-454-b17","series-title":"J Sports Sci","first-page":"690","article-title":"How does knee pain affect trunk and knee motion during badminton forehand lunges","volume":"32","author":"Huang","year":"2014","unstructured":"Huang MT,\nLee HH,\nLin CF,\nTsai YJ,\nLiao JC. 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