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Closed kinetic chain exercises with or without additional hip strengthening exercises in management of patellofemoral pain syndrome: a randomized controlled trial.

Abstract

BACKGROUND

Patellofemoral pain syndrome (PFPS) is a common musculoskeletal pain condition, especially in females. Decreased hip muscle strength has been implicated as a contributing factor. Isolated open kinetic chain hip abductors and lateral rotators exercises were added by many authors to the rehabilitation program. However, Closed Kinetic Chain (CKC) exercises focusing on hip and knee muscles were not investigated if they can produce similar effect of hip strengthening and decreasing pain without the need of isolated exercises for hip musculature.

AIM

The aim of the present study was to determine the effect of a CKC exercises program with or without additional hip strengthening exercises on pain and hip abductors and lateral rotators peak torque.

DESIGN

Prospective randomized clinical trial.

SETTING

Patients with patellofemoral pain syndrome referred to the outpatient physical therapy clinic of the faculty of physical therapy, cairo university.

POPULATION

Thirty two patients who had patellofemoral pain syndrome with age ranged from eighteen to thirty years.

METHODS

Patients were randomly assigned into two groups: CKC group and CKC with hip muscles strengthening exercises as a control (CO) group. Treatment was given 3 times/week, for 6 weeks. Patients were evaluated pre- and post-treatment for their pain severity using VAS, function of knee joint using Kujala questionnaire, hip abductors and external rotators concentric/eccentric peak torque.

RESULTS

There were significant improvements in pain, function and hip muscles peak torque in both groups (P<0.05). However, there was no statistically significant difference between groups in hip muscles torque (P<0.05) but pain and function improvements were significantly greater in the CO group (P<0.05).

CONCLUSION

Six weeks CKC program focusing on knee and hip strengthening has similar effect in improving hip muscles torque in patients with PFPS as a CKC exercises with additional hip strengthening exercises. However, adding isolated hip strengthening exercises has the advantage of more pain relief.

CLINICAL REHABILITATION IMPACT

CKC exercises with additional hip strengthening could be more beneficial in decreasing pain in PFPS than CKC exercises alone.

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  • Authors+Show Affiliations

    ,

    Orthopedic Physical Pherapy Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt - mfarrage69@cu.edu.eg.

    ,

    Source

    MeSH

    Adolescent
    Adult
    Analysis of Variance
    Egypt
    Exercise Therapy
    Female
    Hip Joint
    Humans
    Kinetics
    Knee Joint
    Male
    Muscle Strength
    Pain Measurement
    Patellofemoral Pain Syndrome
    Prospective Studies
    Resistance Training
    Torque
    Treatment Outcome
    Young Adult

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    23820880

    Citation

    Ismail, M M., et al. "Closed Kinetic Chain Exercises With or Without Additional Hip Strengthening Exercises in Management of Patellofemoral Pain Syndrome: a Randomized Controlled Trial." European Journal of Physical and Rehabilitation Medicine, vol. 49, no. 5, 2013, pp. 687-98.
    Ismail MM, Gamaleldein MH, Hassa KA. Closed kinetic chain exercises with or without additional hip strengthening exercises in management of patellofemoral pain syndrome: a randomized controlled trial. Eur J Phys Rehabil Med. 2013;49(5):687-98.
    Ismail, M. M., Gamaleldein, M. H., & Hassa, K. A. (2013). Closed kinetic chain exercises with or without additional hip strengthening exercises in management of patellofemoral pain syndrome: a randomized controlled trial. European Journal of Physical and Rehabilitation Medicine, 49(5), pp. 687-98.
    Ismail MM, Gamaleldein MH, Hassa KA. Closed Kinetic Chain Exercises With or Without Additional Hip Strengthening Exercises in Management of Patellofemoral Pain Syndrome: a Randomized Controlled Trial. Eur J Phys Rehabil Med. 2013;49(5):687-98. PubMed PMID: 23820880.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Closed kinetic chain exercises with or without additional hip strengthening exercises in management of patellofemoral pain syndrome: a randomized controlled trial. AU - Ismail,M M, AU - Gamaleldein,M H, AU - Hassa,K A, Y1 - 2013/07/02/ PY - 2013/7/4/entrez PY - 2013/7/4/pubmed PY - 2014/6/19/medline SP - 687 EP - 98 JF - European journal of physical and rehabilitation medicine JO - Eur J Phys Rehabil Med VL - 49 IS - 5 N2 - BACKGROUND: Patellofemoral pain syndrome (PFPS) is a common musculoskeletal pain condition, especially in females. Decreased hip muscle strength has been implicated as a contributing factor. Isolated open kinetic chain hip abductors and lateral rotators exercises were added by many authors to the rehabilitation program. However, Closed Kinetic Chain (CKC) exercises focusing on hip and knee muscles were not investigated if they can produce similar effect of hip strengthening and decreasing pain without the need of isolated exercises for hip musculature. AIM: The aim of the present study was to determine the effect of a CKC exercises program with or without additional hip strengthening exercises on pain and hip abductors and lateral rotators peak torque. DESIGN: Prospective randomized clinical trial. SETTING: Patients with patellofemoral pain syndrome referred to the outpatient physical therapy clinic of the faculty of physical therapy, cairo university. POPULATION: Thirty two patients who had patellofemoral pain syndrome with age ranged from eighteen to thirty years. METHODS: Patients were randomly assigned into two groups: CKC group and CKC with hip muscles strengthening exercises as a control (CO) group. Treatment was given 3 times/week, for 6 weeks. Patients were evaluated pre- and post-treatment for their pain severity using VAS, function of knee joint using Kujala questionnaire, hip abductors and external rotators concentric/eccentric peak torque. RESULTS: There were significant improvements in pain, function and hip muscles peak torque in both groups (P<0.05). However, there was no statistically significant difference between groups in hip muscles torque (P<0.05) but pain and function improvements were significantly greater in the CO group (P<0.05). CONCLUSION: Six weeks CKC program focusing on knee and hip strengthening has similar effect in improving hip muscles torque in patients with PFPS as a CKC exercises with additional hip strengthening exercises. However, adding isolated hip strengthening exercises has the advantage of more pain relief. CLINICAL REHABILITATION IMPACT: CKC exercises with additional hip strengthening could be more beneficial in decreasing pain in PFPS than CKC exercises alone. SN - 1973-9095 UR - https://www.unboundmedicine.com/medline/citation/23820880/Closed_kinetic_chain_exercises_with_or_without_additional_hip_strengthening_exercises_in_management_of_patellofemoral_pain_syndrome:_a_randomized_controlled_trial_ L2 - http://www.minervamedica.it/index2.t?show=R33Y2013N05A0687 DB - PRIME DP - Unbound Medicine ER -