Is hip strengthening the best treatment option for females with patellofemoral pain? A randomized controlled trial of three different types of exercises

•It is commonly believed that hip dysfunctions have been responsible for PFP onset.•Several forms of treatment (HE, QE and SE) can be effective in decreasing PFPS pain.•Only interventions with strengthening exercises were able to change movement patterns.•More effective rehabilitation programs shoul...

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Published in:	Revista brasileira de fisioterapia (São Carlos (São Paulo, Brazil)) Vol. 22; no. 5; pp. 408 - 416
Main Authors:	Saad, Marcelo Camargo, Vasconcelos, Rodrigo Antunes de, Mancinelli, Letícia Villani de Oliveira, Munno, Matheus Soares de Barros, Liporaci, Rogério Ferreira, Grossi, Débora Bevilaqua
Format:	Journal Article
Language:	English
Published:	Brazil Elsevier Editora Ltda 01-09-2018 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
Subjects:	Adolescent Adult Anterior knee pain Biomechanical Phenomena Exercise Therapy - methods Female Hip Humans Muscle Strength Original Research Pain Management - methods Patellofemoral Pain Syndrome - physiopathology Patellofemoral Pain Syndrome - therapy Quadriceps and hip muscles Recovery of Function Rehabilitation Single-Blind Method Step up and down kinematics Young Adult Anterior knee pain Rehabilitation Step up and down kinematics Quadriceps and hip muscles
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Summary:	•It is commonly believed that hip dysfunctions have been responsible for PFP onset.•Several forms of treatment (HE, QE and SE) can be effective in decreasing PFPS pain.•Only interventions with strengthening exercises were able to change movement patterns.•More effective rehabilitation programs should focus on the deficits presented by individuals in their initial evaluations. To evaluate the effect of three types of exercise intervention in patients with patellofemoral pain and to verify the contributions of each intervention to pain control, function, and lower extremity kinematics. A randomized controlled, single-blinded trial was conducted. Forty women with patellofemoral pain were randomly allocated into four groups: hip exercises, quadriceps exercises, stretching exercises and a control group (no intervention). Pain (using a visual analog scale), function (using the Anterior Knee Pain Scale), hip and quadriceps strength (using a handheld isometric dynamometer) and measuring lower limb kinematics during step up and down activities were evaluated at baseline and 8 weeks post intervention. All treatment groups showed significant improvements on pain and Anterior Knee Pain Scale after intervention with no statistically significant differences between groups except when compared to the control group. Only hip and quadriceps groups demonstrated improvements in muscle strength and knee valgus angle during the step activities. Hip strengthening exercises were not more effective for pain relief and function compared to quadriceps or stretching exercises in females with patellofemoral pain. Only hip and quadriceps groups were able to decrease the incidence of dynamic valgus during step-down activity. This study was approved by Brazilian Clinical Trials Registry registration number: RBR-6tc7mj (http://www.ensaiosclinicos.gov.br/rg/RBR-6tc7mj/).
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	1413-3555 1809-9246
DOI:	10.1016/j.bjpt.2018.03.009