{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:28:28Z","timestamp":1787030908635,"version":"build-2736575974"},"reference-count":36,"publisher":"National Athletic Trainers' Association","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>People with patellofemoral pain (PFP) may have lower performance during the forward step-down and single-leg hop with their painful (unilateral complaints) or most painful (bilateral complaints) limb when compared with pain-free controls. However, no authors have investigated the appropriateness of using the pain-free or less painful limb as a reference standard in clinical practice or whether deficits might be present depending on the laterality of pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare performance scores and proportion of side-to-side limb symmetry during the forward step-down and single-leg hop tests among people with unilateral and bilateral PFP and pain-free controls.<\/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>Fifty-two young adults (18\u201335 years old) with unilateral PFP, 72 with bilateral PFP, and 76 controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>Group \u00d7 limb interactions on performance during the step-down (repetitions) and single-leg hop (distance [cm] normalized by the limb length) tests were investigated using a repeated-measures analysis of covariance controlling for sex. Pairwise comparisons were interpreted using effect sizes. A \u03c72 test was used to compare the proportion of symmetry\/asymmetry (cutoff point of \u226590% for symmetry indices) across groups and tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Main effects for groups (small to medium effects) but not limbs indicated lower performance of both limbs of individuals with unilateral and bilateral PFP than controls during forward step-down and single-leg hop tests. No significant differences for the proportion of symmetry\/asymmetry were identified across groups (P \u2265.05), which further suggests an impaired physical performance of the contralateral limb.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results indicate bilateral deficits in the physical performance of people with unilateral and bilateral PFP when compared with pain-free controls during the forward step-down and single-leg hop tests. Limb symmetry indices greater than 90% should be interpreted with caution, as they may overstate physical performance by not assuming bilateral deficits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4085\/1062-6050-0649.23","type":"journal-article","created":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T05:17:34Z","timestamp":1710307054000},"page":"1110-1117","source":"Crossref","is-referenced-by-count":9,"title":["People With Patellofemoral Pain Have Bilateral Deficits in Physical Performance Regardless of Pain Laterality"],"prefix":"10.4085","volume":"59","author":[{"given":"Marina C.","family":"Waiteman","sequence":"first","affiliation":[{"name":"* School of Science and Technology, Department of Physical Therapy, S\u00e3o Paulo State University, Presidente Prudente, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronaldo V.","family":"Briani","sequence":"additional","affiliation":[{"name":"* School of Science and Technology, Department of Physical Therapy, S\u00e3o Paulo State University, Presidente Prudente, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helder S.","family":"Lopes","sequence":"additional","affiliation":[{"name":"* School of Science and Technology, Department of Physical Therapy, S\u00e3o Paulo State University, Presidente Prudente, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus H.","family":"Maiolini Ducatti","sequence":"additional","affiliation":[{"name":"* School of Science and Technology, Department of Physical Therapy, S\u00e3o Paulo State University, Presidente Prudente, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gleison G.M.","family":"da Silva","sequence":"additional","affiliation":[{"name":"* School of Science and Technology, Department of Physical Therapy, S\u00e3o Paulo State University, Presidente Prudente, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Bazett-Jones","sequence":"additional","affiliation":[{"name":"\u2020 Department of Exercise and Rehabilitation Sciences, College of Health and Human Services, University of Toledo, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F\u00e1bio M.","family":"de Azevedo","sequence":"additional","affiliation":[{"name":"* School of Science and Technology, Department of Physical Therapy, S\u00e3o Paulo State University, Presidente Prudente, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","published-online":{"date-parts":[[2024,11,25]]},"reference":[{"issue":"2","key":"2024112509163273400_i1938-162X-59-11-1110-b01","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1093\/rheumatology\/keg093","article-title":"Anterior knee pain: a long-term follow-up","volume":"42","author":"Stathopulu","year":"2003","journal-title":"Rheumatology (Oxford)"},{"issue":"1","key":"2024112509163273400_i1938-162X-59-11-1110-b02","doi-asserted-by":"crossref","first-page":"e0190892","DOI":"10.1371\/journal.pone.0190892","article-title":"Incidence and prevalence of patellofemoral pain: a systematic review and meta-analysis","volume":"13","author":"Smith","year":"2018","journal-title":"PLoS One"},{"issue":"14","key":"2024112509163273400_i1938-162X-59-11-1110-b03","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1136\/bjsports-2015-094664","article-title":"Factors that predict a poor outcome 5\u20138 years after the diagnosis of patellofemoral pain: a multicentre observational analysis","volume":"50","author":"Lankhorst","year":"2015","journal-title":"Br J Sports Med"},{"key":"2024112509163273400_i1938-162X-59-11-1110-b04","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ptsp.2022.05.011","article-title":"Living well (or not) with patellofemoral pain: a qualitative study","volume":"56","author":"Glaviano","year":"2022","journal-title":"Phys Ther Sport"},{"issue":"9","key":"2024112509163273400_i1938-162X-59-11-1110-b05","doi-asserted-by":"crossref","first-page":"CPG1","DOI":"10.2519\/jospt.2019.0302","article-title":"Patellofemoral pain","volume":"49","author":"Willy","year":"2019","journal-title":"J Orthop Sports Phys Ther"},{"issue":"24","key":"2024112509163273400_i1938-162X-59-11-1110-b06","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1136\/bjsports-2022-105510","article-title":"What tests should be used to assess functional performance in youth and young adults following anterior cruciate ligament or meniscal injury? 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