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Hip and knee strength is not affected in 12-16 year old adolescents with patellofemoral pain--a cross-sectional population-based study.
PLoS One. 2013; 8(11):e79153.Plos

Abstract

BACKGROUND

One of the rationales behind using strength training in the treatment of adolescents with Patellofemoral Pain (PFP) is that reduced strength of the lower extremity is a risk factor for PFP and a common deficit. This rationale is based on research conducted on adolescents >15 years of age but has never been investigated among young adolescents with PFP.

OBJECTIVES

To compare isometric muscle strength of the lower extremity among adolescents with PFP compared to age- and gender-matched pain-free adolescents.

METHODS

In 2011 a population-based cohort (APA2011-cohort) consisting of 768 adolescents aged 12-15 years from 8 local schools was formed. In September 2012, all adolescents who reported knee pain in September 2011 were offered a clinical examination if they still had knee pain. From these, 20 adolescents (16 females) were diagnosed with PFP. Pain-free adolescents from the APA2011-cohort (n = 20) were recruited on random basis as age- and gender-matched pairs. Primary outcome was isometric knee extension strength normalized to body weight (%BW) and blinded towards subject information. Secondary outcomes included knee flexion, hip abduction/adduction and hip internal/external rotation strength. Demographic data included Knee Injury and Osteoarthritis Outcome Score (KOOS) and symptom duration.

RESULTS

Adolescents with PFP reported long symptom duration and significantly worse KOOS scores compared to pain-free adolescents. There were no significant differences in isometric knee extension strength (Δ0.3% BW, p = 0.97), isometric knee flexion strength (Δ0.4% BW, p = 0.84) or different measures of hip strength (Δ0.4 to 1.1% BW, p>0.35).

CONCLUSION

Young symptomatic adolescents with PFP between 12 and 16 years of age did not have decreased isometric muscle strength of the knee and hip. These results question the rationale of targeting strength deficits in the treatment of adolescents with PFP. However, strength training may still be an effective treatment for those individuals with PFP suffering from strength deficits.

Authors+Show Affiliations

Orthopaedic Surgery Research Unit, Aalborg University Hospital, Aalborg, Denmark.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24236101

Citation

Rathleff, Camilla Rams, et al. "Hip and Knee Strength Is Not Affected in 12-16 Year Old Adolescents With Patellofemoral Pain--a Cross-sectional Population-based Study." PloS One, vol. 8, no. 11, 2013, pp. e79153.
Rathleff CR, Baird WN, Olesen JL, et al. Hip and knee strength is not affected in 12-16 year old adolescents with patellofemoral pain--a cross-sectional population-based study. PLoS ONE. 2013;8(11):e79153.
Rathleff, C. R., Baird, W. N., Olesen, J. L., Roos, E. M., Rasmussen, S., & Rathleff, M. S. (2013). Hip and knee strength is not affected in 12-16 year old adolescents with patellofemoral pain--a cross-sectional population-based study. PloS One, 8(11), e79153. https://doi.org/10.1371/journal.pone.0079153
Rathleff CR, et al. Hip and Knee Strength Is Not Affected in 12-16 Year Old Adolescents With Patellofemoral Pain--a Cross-sectional Population-based Study. PLoS ONE. 2013;8(11):e79153. PubMed PMID: 24236101.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hip and knee strength is not affected in 12-16 year old adolescents with patellofemoral pain--a cross-sectional population-based study. AU - Rathleff,Camilla Rams, AU - Baird,William Neill, AU - Olesen,Jens Lykkegaard, AU - Roos,Ewa Maria, AU - Rasmussen,Sten, AU - Rathleff,Michael Skovdal, Y1 - 2013/11/13/ PY - 2013/06/21/received PY - 2013/09/26/accepted PY - 2013/11/16/entrez PY - 2013/11/16/pubmed PY - 2014/9/3/medline SP - e79153 EP - e79153 JF - PloS one JO - PLoS ONE VL - 8 IS - 11 N2 - BACKGROUND: One of the rationales behind using strength training in the treatment of adolescents with Patellofemoral Pain (PFP) is that reduced strength of the lower extremity is a risk factor for PFP and a common deficit. This rationale is based on research conducted on adolescents >15 years of age but has never been investigated among young adolescents with PFP. OBJECTIVES: To compare isometric muscle strength of the lower extremity among adolescents with PFP compared to age- and gender-matched pain-free adolescents. METHODS: In 2011 a population-based cohort (APA2011-cohort) consisting of 768 adolescents aged 12-15 years from 8 local schools was formed. In September 2012, all adolescents who reported knee pain in September 2011 were offered a clinical examination if they still had knee pain. From these, 20 adolescents (16 females) were diagnosed with PFP. Pain-free adolescents from the APA2011-cohort (n = 20) were recruited on random basis as age- and gender-matched pairs. Primary outcome was isometric knee extension strength normalized to body weight (%BW) and blinded towards subject information. Secondary outcomes included knee flexion, hip abduction/adduction and hip internal/external rotation strength. Demographic data included Knee Injury and Osteoarthritis Outcome Score (KOOS) and symptom duration. RESULTS: Adolescents with PFP reported long symptom duration and significantly worse KOOS scores compared to pain-free adolescents. There were no significant differences in isometric knee extension strength (Δ0.3% BW, p = 0.97), isometric knee flexion strength (Δ0.4% BW, p = 0.84) or different measures of hip strength (Δ0.4 to 1.1% BW, p>0.35). CONCLUSION: Young symptomatic adolescents with PFP between 12 and 16 years of age did not have decreased isometric muscle strength of the knee and hip. These results question the rationale of targeting strength deficits in the treatment of adolescents with PFP. However, strength training may still be an effective treatment for those individuals with PFP suffering from strength deficits. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/24236101/Hip_and_knee_strength_is_not_affected_in_12_16_year_old_adolescents_with_patellofemoral_pain__a_cross_sectional_population_based_study_ L2 - http://dx.plos.org/10.1371/journal.pone.0079153 DB - PRIME DP - Unbound Medicine ER -