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Hip strengthening prior to functional exercises reduces pain sooner than quadriceps strengthening in females with patellofemoral pain syndrome: a randomized clinical trial.
J Orthop Sports Phys Ther. 2011 Aug; 41(8):560-70.JO

Abstract

STUDY DESIGN

Randomized clinical trial.

OBJECTIVES

To determine if females with patellofemoral pain syndrome (PFPS) who perform hip strengthening prior to functional exercises demonstrate greater improvements than females who perform quadriceps strengthening prior to the same functional exercises.

BACKGROUND

Although PFPS has previously been attributed to quadriceps dysfunction, more recent research has linked this condition to impairment of the hip musculature. Lower extremity strengthening has been deemed an effective intervention. However, research has often examined weight-bearing exercises, making it unclear if increased strength in the hip, quadriceps, or both is beneficial.

METHODS

Thirty-three females with PFPS performed either initial hip strengthening (hip group) or initial quadriceps strengthening (quad group) for 4 weeks, prior to 4 weeks of a similar program of functional weight-bearing exercises. Self-reported pain, function, and functional strength were measured. Isometric strength was assessed for hip abductors, external rotators, and knee extensors. A mixed-model analysis of variance was used to determine group differences over time.

RESULTS

After 4 weeks, there was less mean ± SD pain in the hip group (2.4 ± 2.0) than in the quad group (4.1 ± 2.5) (P = .035). From baseline to 8 weeks, the hip group demonstrated a 21% increase (P<.001) in hip abductor strength, while that remained unchanged in the quad group. All participants demonstrated improved subjective function (P<.006), objective function (P<.001), and hip external rotator strength (P = .004) from baseline to testing at 8 weeks.

CONCLUSION

Both rehabilitation approaches improved function and reduced pain. For patients with PFPS, initial hip strengthening may allow an earlier dissipation of pain than exercises focused on the quadriceps.

Authors+Show Affiliations

Boston University, Boston, MA 02215, USA. Kimberly.Dolak@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21654093

Citation

Dolak, Kimberly L., et al. "Hip Strengthening Prior to Functional Exercises Reduces Pain Sooner Than Quadriceps Strengthening in Females With Patellofemoral Pain Syndrome: a Randomized Clinical Trial." The Journal of Orthopaedic and Sports Physical Therapy, vol. 41, no. 8, 2011, pp. 560-70.
Dolak KL, Silkman C, Medina McKeon J, et al. Hip strengthening prior to functional exercises reduces pain sooner than quadriceps strengthening in females with patellofemoral pain syndrome: a randomized clinical trial. J Orthop Sports Phys Ther. 2011;41(8):560-70.
Dolak, K. L., Silkman, C., Medina McKeon, J., Hosey, R. G., Lattermann, C., & Uhl, T. L. (2011). Hip strengthening prior to functional exercises reduces pain sooner than quadriceps strengthening in females with patellofemoral pain syndrome: a randomized clinical trial. The Journal of Orthopaedic and Sports Physical Therapy, 41(8), 560-70. https://doi.org/10.2519/jospt.2011.3499
Dolak KL, et al. Hip Strengthening Prior to Functional Exercises Reduces Pain Sooner Than Quadriceps Strengthening in Females With Patellofemoral Pain Syndrome: a Randomized Clinical Trial. J Orthop Sports Phys Ther. 2011;41(8):560-70. PubMed PMID: 21654093.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hip strengthening prior to functional exercises reduces pain sooner than quadriceps strengthening in females with patellofemoral pain syndrome: a randomized clinical trial. AU - Dolak,Kimberly L, AU - Silkman,Carrie, AU - Medina McKeon,Jennifer, AU - Hosey,Robert G, AU - Lattermann,Christian, AU - Uhl,Timothy L, Y1 - 2011/06/07/ PY - 2011/6/10/entrez PY - 2011/6/10/pubmed PY - 2011/12/14/medline SP - 560 EP - 70 JF - The Journal of orthopaedic and sports physical therapy JO - J Orthop Sports Phys Ther VL - 41 IS - 8 N2 - STUDY DESIGN: Randomized clinical trial. OBJECTIVES: To determine if females with patellofemoral pain syndrome (PFPS) who perform hip strengthening prior to functional exercises demonstrate greater improvements than females who perform quadriceps strengthening prior to the same functional exercises. BACKGROUND: Although PFPS has previously been attributed to quadriceps dysfunction, more recent research has linked this condition to impairment of the hip musculature. Lower extremity strengthening has been deemed an effective intervention. However, research has often examined weight-bearing exercises, making it unclear if increased strength in the hip, quadriceps, or both is beneficial. METHODS: Thirty-three females with PFPS performed either initial hip strengthening (hip group) or initial quadriceps strengthening (quad group) for 4 weeks, prior to 4 weeks of a similar program of functional weight-bearing exercises. Self-reported pain, function, and functional strength were measured. Isometric strength was assessed for hip abductors, external rotators, and knee extensors. A mixed-model analysis of variance was used to determine group differences over time. RESULTS: After 4 weeks, there was less mean ± SD pain in the hip group (2.4 ± 2.0) than in the quad group (4.1 ± 2.5) (P = .035). From baseline to 8 weeks, the hip group demonstrated a 21% increase (P<.001) in hip abductor strength, while that remained unchanged in the quad group. All participants demonstrated improved subjective function (P<.006), objective function (P<.001), and hip external rotator strength (P = .004) from baseline to testing at 8 weeks. CONCLUSION: Both rehabilitation approaches improved function and reduced pain. For patients with PFPS, initial hip strengthening may allow an earlier dissipation of pain than exercises focused on the quadriceps. SN - 1938-1344 UR - https://www.unboundmedicine.com/medline/citation/21654093/Hip_strengthening_prior_to_functional_exercises_reduces_pain_sooner_than_quadriceps_strengthening_in_females_with_patellofemoral_pain_syndrome:_a_randomized_clinical_trial_ L2 - https://www.jospt.org/doi/10.2519/jospt.2011.3499?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -