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Hip posterolateral musculature strengthening in sedentary women with patellofemoral pain syndrome: a randomized controlled clinical trial with 1-year follow-up.

Abstract

STUDY DESIGN

Randomized controlled trial.

OBJECTIVES

To determine if adding hip-strengthening exercises to a conventional knee exercise program produces better long-term outcomes than conventional knee exercises alone in women with patellofemoral pain syndrome (PFPS).

BACKGROUND

Recent studies have shown that a hip-strengthening program reduces pain and improves function in individuals with PFPS. However, there are no clinical trials evaluating long-term outcomes of this type of program compared to conventional knee-strengthening and -stretching exercises.

METHODS

Fifty-four sedentary women between 20 and 40 years of age, with a diagnosis of unilateral PFPS, were randomly assigned knee exercise (KE) or knee and hip exercise (KHE). The women in the KE group (n = 26; mean age, 23 years) performed a 4-week conventional knee-stretching and -strengthening program. The women in the KHE group (n = 28; mean age, 22 years) performed the same exercises as those in the KE group, as well as strengthening exercises for the hip abductors, lateral rotators, and extensors. An 11-point numeric pain rating scale, the Lower Extremity Functional Scale, the Anterior Knee Pain Scale, and a single-hop test were used as outcome measures at baseline (pretreatment) and 3, 6, and 12 months posttreatment.

RESULTS

At baseline, demographic, pain, and functional assessment data were similar between groups. Those in the KHE group had a higher level of function and less pain at 3, 6, and 12 months compared to baseline (P<.05). In contrast, the KE group had reduced pain only at the 3- and 6-month follow-ups (P<.05), without any changes in Lower Extremity Functional Scale, Anterior Knee Pain Scale, or hop testing (P>.05) through the course of the study. Compared to the KE group, the KHE group had less pain and better function at 3, 6, and 12 months posttreatment (P<.05). For the Lower Extremity Functional Scale, the between-group difference in change scores from baseline at 3, 6, and 12 months posttreatment favored the KHE group by 22.0, 22.0, and 20.8 points, respectively.

CONCLUSION

Knee-stretching and -strengthening exercises supplemented by hip posterolateral musculature-strengthening exercises were more effective than knee exercises alone in improving long-term function and reducing pain in sedentary women with PFPS.

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  • Authors+Show Affiliations

    ,

    Department of Physical Therapy, Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP), Centro Universitário SãoCamilo (CUSC), São Paulo-SP, Brazil. tfukuda10@yahoo.com.br

    , , , , ,

    Source

    MeSH

    Adult
    Female
    Follow-Up Studies
    Hip
    Humans
    Knee
    Muscle Strength
    Muscle Stretching Exercises
    Muscle, Skeletal
    Pain Measurement
    Patellofemoral Pain Syndrome
    Prospective Studies
    Resistance Training
    Sedentary Behavior
    Young Adult

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    22951491

    Citation

    Fukuda, Thiago Yukio, et al. "Hip Posterolateral Musculature Strengthening in Sedentary Women With Patellofemoral Pain Syndrome: a Randomized Controlled Clinical Trial With 1-year Follow-up." The Journal of Orthopaedic and Sports Physical Therapy, vol. 42, no. 10, 2012, pp. 823-30.
    Fukuda TY, Melo WP, Zaffalon BM, et al. Hip posterolateral musculature strengthening in sedentary women with patellofemoral pain syndrome: a randomized controlled clinical trial with 1-year follow-up. J Orthop Sports Phys Ther. 2012;42(10):823-30.
    Fukuda, T. Y., Melo, W. P., Zaffalon, B. M., Rossetto, F. M., Magalhães, E., Bryk, F. F., & Martin, R. L. (2012). Hip posterolateral musculature strengthening in sedentary women with patellofemoral pain syndrome: a randomized controlled clinical trial with 1-year follow-up. The Journal of Orthopaedic and Sports Physical Therapy, 42(10), pp. 823-30. doi:10.2519/jospt.2012.4184.
    Fukuda TY, et al. Hip Posterolateral Musculature Strengthening in Sedentary Women With Patellofemoral Pain Syndrome: a Randomized Controlled Clinical Trial With 1-year Follow-up. J Orthop Sports Phys Ther. 2012;42(10):823-30. PubMed PMID: 22951491.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Hip posterolateral musculature strengthening in sedentary women with patellofemoral pain syndrome: a randomized controlled clinical trial with 1-year follow-up. AU - Fukuda,Thiago Yukio, AU - Melo,William Pagotti, AU - Zaffalon,Bruno Marcos, AU - Rossetto,Flavio Marcondes, AU - Magalhães,Eduardo, AU - Bryk,Flavio Fernandes, AU - Martin,Robroy L, Y1 - 2012/08/02/ PY - 2012/9/7/entrez PY - 2012/9/7/pubmed PY - 2013/3/26/medline SP - 823 EP - 30 JF - The Journal of orthopaedic and sports physical therapy JO - J Orthop Sports Phys Ther VL - 42 IS - 10 N2 - STUDY DESIGN: Randomized controlled trial. OBJECTIVES: To determine if adding hip-strengthening exercises to a conventional knee exercise program produces better long-term outcomes than conventional knee exercises alone in women with patellofemoral pain syndrome (PFPS). BACKGROUND: Recent studies have shown that a hip-strengthening program reduces pain and improves function in individuals with PFPS. However, there are no clinical trials evaluating long-term outcomes of this type of program compared to conventional knee-strengthening and -stretching exercises. METHODS: Fifty-four sedentary women between 20 and 40 years of age, with a diagnosis of unilateral PFPS, were randomly assigned knee exercise (KE) or knee and hip exercise (KHE). The women in the KE group (n = 26; mean age, 23 years) performed a 4-week conventional knee-stretching and -strengthening program. The women in the KHE group (n = 28; mean age, 22 years) performed the same exercises as those in the KE group, as well as strengthening exercises for the hip abductors, lateral rotators, and extensors. An 11-point numeric pain rating scale, the Lower Extremity Functional Scale, the Anterior Knee Pain Scale, and a single-hop test were used as outcome measures at baseline (pretreatment) and 3, 6, and 12 months posttreatment. RESULTS: At baseline, demographic, pain, and functional assessment data were similar between groups. Those in the KHE group had a higher level of function and less pain at 3, 6, and 12 months compared to baseline (P<.05). In contrast, the KE group had reduced pain only at the 3- and 6-month follow-ups (P<.05), without any changes in Lower Extremity Functional Scale, Anterior Knee Pain Scale, or hop testing (P>.05) through the course of the study. Compared to the KE group, the KHE group had less pain and better function at 3, 6, and 12 months posttreatment (P<.05). For the Lower Extremity Functional Scale, the between-group difference in change scores from baseline at 3, 6, and 12 months posttreatment favored the KHE group by 22.0, 22.0, and 20.8 points, respectively. CONCLUSION: Knee-stretching and -strengthening exercises supplemented by hip posterolateral musculature-strengthening exercises were more effective than knee exercises alone in improving long-term function and reducing pain in sedentary women with PFPS. SN - 1938-1344 UR - https://www.unboundmedicine.com/medline/citation/22951491/Hip_posterolateral_musculature_strengthening_in_sedentary_women_with_patellofemoral_pain_syndrome:_a_randomized_controlled_clinical_trial_with_1_year_follow_up_ L2 - http://www.jospt.org/doi/full/10.2519/jospt.2012.4184?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -