Task-specific movement training improves kinematics and pain during the Y-balance test and hip muscle strength in females with patellofemoral pain

2021 ◽  
pp. jisakos-2020-000551
Author(s):  
Elanna K Arhos ◽  
Catherine E Lang ◽  
Karen Steger-May ◽  
Linda R Van Dillen ◽  
Barbara Yemm ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Knee Kinematics ◽  
Patellofemoral Pain ◽  
Composite Score ◽  
Secondary Outcome ◽  
Balance Test ◽  
Control Phase ◽  
Intervention Phase ◽  
Movement Training ◽  
Hip Muscle

ObjectivesTask-specific movement training is a proposed intervention for patellofemoral pain aimed to optimise movement during daily tasks. Focused, progressive task practice emphasising optimal limb alignment may yield improvements in performance-based function and hip muscle strength, and transfer learnt movement patterns to untrained tasks. The purpose of this study was to determine if task-specific movement training improves performance-based function (composite score, movement, pain during movement) in an untrained task. Our secondary purpose was to test whether hip muscle strength improved following the movement training intervention.MethodsThis study was a secondary analysis of a prospective, non-randomised, within-group, double-baseline study. Twenty-three females with patellofemoral pain underwent task-specific movement training two times/week for 6 weeks. Outcomes were collected at three time points: enrolment (baseline), 6 weeks (preintervention) and 12 weeks (postintervention). A repeated measures analysis of variance tested whether the change during the intervention phase was greater than the change during the control phase. Y-balance composite score, hip and knee kinematics and pain during the Y-balance test were primary outcome measures; strength of the hip lateral rotator, abductor and extensor muscles was a secondary outcome measure.ResultsThe change in composite score for the Y-balance test was not statistically significantly different between the intervention and control phases (p=0.16). The change during the intervention phase exceeded the change during the control phase for hip and knee kinematics and pain during the Y-balance test, with all variables improving (p<0.0001). The change during the intervention phase was greater than the control phase for hip muscle strength, with all variables improving (p<0.04).ConclusionAlthough the Y-balance test composite score did not improve, performance-based function during an untrained task, measured by movement and pain during the test, improved following task-specific movement training. Hip muscle strength improved, despite no focused muscle strengthening.Level of evidenceLevel II.

scholarly journals Effect of Agility and Perturbation Training on Pain, Balance and Functional Ability in Subjects with Patellofemoral Pain Syndrome

2021 ◽  
Vol 11 (7) ◽  
pp. 204-226
Author(s):  
Kalpana . ◽  
Mohan Kumar Muniyan ◽  
A M R Suresh
Keyword(s):  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Composite Score ◽  
Functional Abilities ◽  
Post Intervention ◽  
Balance Test ◽  
Perturbation Training ◽  
Kujala Score ◽  
Significant Difference

Background: Agility and Perturbation training have been advocated to improve pain, balance and functional abilities in subjects with osteoarthritis of knee but effect of same on Patellofemoral pain have not been explored in studies. The above techniques would be helpful along with standard rehabilitation programs in reducing dynamic knee instability or improving dynamic stability upon return to high level physical activity and have an additive effect of reducing pain in OA knee. Objective: The purpose of the study is to find the effect of Agility and Perturbation training on improvement of pain, balance and functional abilities in subject with Patellofemoral Pain Syndrome. Method: A randomized controlled study with 40 individuals has been taken with patellofemoral pain syndrome. 20 subjects have been selected for control group and 20 subjects for study group. Outcome measures includes Kujala function scale, Y balance test and Numeric pain rating scale were measured before and immediately after the treatment. Results: Analysis using Mann Whitney U Test and Independent t between the groups found that when pre intervention means of NPRS, Composite score YBT and Kujala Score were compared there is a statistically significant difference between the groups. When post intervention means of NPRS and Kujala score were compared between the groups there is no statistically significant difference between the groups. When post intervention means of Composite score YBT were compared there is a statically significant difference. Conclusion: The present study concludes that Agility and Perturbation training shown significant improvement of pain, function and balance in subject with Patellofemoral Pain Syndrome. Key words: Patellofemoral Pain Syndrome, Kujala function Scale, Y balance test.

scholarly journals Which is the best predictor of excessive hip internal rotation in women with patellofemoral pain: Rearfoot eversion or hip muscle strength? Exploring subgroups

2018 ◽  
Vol 62 ◽  
pp. 366-371 ◽  
Author(s):  
Amanda Schenatto Ferreira ◽  
Danilo de Oliveira Silva ◽  
Ronaldo Valdir Briani ◽  
Deisi Ferrari ◽  
Fernando Amâncio Aragão ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Internal Rotation ◽  
Patellofemoral Pain ◽  
Hip Muscle ◽  
Rearfoot Eversion ◽  
Hip Internal Rotation

scholarly journals The Effectiveness Of Quadriceps Strengthening Exercises Combined With Neuromuscular Electrical Stimulation on Patellofemoral Pain Syndrome

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0010
Author(s):  
Sezen Karabörklü Argut ◽  
Nilgün Türker ◽  
Derya Çelik ◽  
Önder İsmet Kılıçoğlu
Keyword(s):  
Electrical Stimulation ◽  
Muscle Strength ◽  
Neuromuscular Electrical Stimulation ◽  
Pain Syndrome ◽  
Quadriceps Strength ◽  
Patellofemoral Pain ◽  
Group I ◽  
Strengthening Exercises ◽  
Group Ii ◽  
And Function

Objective: The weakness of the quadriceps strength in patellofemoral pain syndrome (PFPS) is very evident. Therefore, quadriceps strengthening exercises are very important part of the rehabilitation program. Neuromuscular Electrical Stimulation (NMES) is considered one of the methods for increasing quadriceps muscle strength. To evaluate the effectiveness of combined NMES and strengthening exercises to improve the recovery of quadriceps strength and function in patients with PFPS. Methods: This study was planned as a randomized controlled pilot study. A total of 27 patients (mean age=38.9±10.8 years, range=20-60 years; 16 females) with PFPS were assessed and randomly assigned into 2 groups. Group I received a standard program (quadriceps strengthening, hip strengthening and hamstring stretching) and NMES combined with quadriceps strengthening exercises simultaneously. Group II received the same standard program without NMES. Both groups were enrolled 3 times per week for 40 minutes per day in 6 weeks. Patients were assessed at the baseline, 3 rd, 6th, and 12th weeks of treatment. Quadriceps strength was evaluated by isokinetic dynamometer. The range of motion at testing was set between 0 for extension to 90 for flexion. The test was performed at 60 degrees/sn and concentric maximum peak torque value was recorded. Kujala and Lysholm scores were used for functional assessments. The data were analyzed using the SPSS 20.0. Shapiro-Wilk test was used to assess the distribution of data. The changes in dependent variables before treatment, 3 rd, 6th, and 12th weeks were analyzed using a 2 by 4 mixed-model analysis of variance (ANOVA). Pairwise comparisons with paired t test were used to determine whether the Group I or Group II, has changed over time. An intention- to- treat analysis was performed to impute values for missing data. An alpha level of 0.05 was established. Results: The study was completed with 20 patients. Group I (n=10; mean age=39.4±8.5 years; 7 females) and group II (n=10; mean age=43.2±11.7 years; 5 females) had no differences in pre-operative measures (p>.05). There was significant improvements in within groups statistics of all parameters for both groups (p<.05). No differences in quadriceps strength, Kujala and Lysholm scores between groups were found at the different time points (F= 0.86; p = 0.12, F=0,001; p =0.97, F=0.12; p=0.73, respectively) Conclusion: NMES combined with quadriceps strengthening exercises has no additional effect on PFPS patients’ on muscle strength and function. When considering these results, we believe that there is no need to continue the study in progress. [Table: see text]

scholarly journals Is Hip Muscle Strength Associated with Dynamic Knee Valgus in a Healthy Adult Population? A Systematic Review

2021 ◽  
Vol 18 (14) ◽  
pp. 7669
Author(s):  
Ali Mohammed Alzahrani ◽  
Msaad Alzhrani ◽  
Saeed Nasser Alshahrani ◽  
Wael Alghamdi ◽  
Mazen Alqahtani ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Adult Population ◽  
Knee Valgus ◽  
Journal Articles ◽  
Hip Muscle ◽  
Hip Abductor ◽  
Hip Muscles ◽  
Analysis System ◽  
The Relationship ◽  
External Rotator

This study aimed to systematically review research investigating the association between hip muscle strength and dynamic knee valgus (DKV). Four databases (MEDLINE, PubMed, CINAHL, and SPORTDiscus) were searched for journal articles published from inception to October 2020. Seven studies investigating the association between hip muscle strength and DKV using a two-dimensional motion analysis system in healthy adults were included. The relationship between hip abductor muscle strength and DKV was negatively correlated in two studies, positively correlated in two studies, and not correlated in three studies. The DKV was associated with reduced hip extensor muscle strength in two studies and reduced hip external rotator muscle strength in two studies, while no correlation was found in three and five studies for each muscle group, respectively. The relationship between hip muscle strength, including abductors, extensors, and external rotators and DKV is conflicting. Considering the current literature limitations and variable methodological approaches used among studies, the clinical relevance of such findings should be interpreted cautiously. Therefore, future studies are recommended to measure the eccentric strength of hip muscles, resembling muscular movement during landing. Furthermore, high-demand and sufficiently challenging functional tasks revealing lower limb kinematic differences, such as cutting and jumping tasks, are recommended for measuring the DKV.

scholarly journals Combined Hip Abductor and External Rotator Strengthening and Hip Internal Rotator Stretching Improves Pain and Function in Patients With Patellofemoral Pain Syndrome: A Randomized Controlled Trial With Crossover Design

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712198972
Author(s):  
Anis Jellad ◽  
Amine Kalai ◽  
Mohamed Guedria ◽  
Mahbouba Jguirim ◽  
Sana Elmhamdi ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Level Of Evidence ◽  
Randomized Controlled ◽  
Group Standard ◽  
Hip Muscle ◽  
And Function

Background: Active rehabilitation has an important role in the management of patellofemoral pain syndrome (PFPS). Although some studies have shown the benefit of hip-muscle strengthening, the effect of combining hip-muscle stretching with strengthening has not yet been defined. Purpose: To evaluate the effect of combined strengthening of the hip external rotators and abductors and stretching of the hip internal rotators on pain and function in patients with PFPS. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A total of 109 patients with PFPS (75 female and 34 male; mean age, 31.6 ± 10.8 years) were first randomly assigned to protocol A (n = 67) of the A-B arm (AB group; standard rehabilitation) or protocol B (n = 42) of the B-A arm (BA group; standard rehabilitation with strengthening of the hip external rotators and abductors and stretching of the hip internal rotators). Each protocol consisted of 3 sessions a week for 4 weeks. After a washout period, corresponding to a symptom-free period, rehabilitation programs were crossed over. A visual analog scale (VAS) evaluating perceived pain, the Functional Index Questionnaire (FIQ), and the Kujala score were administered at baseline, the end of each rehabilitation protocol, and 12 weeks after the completion of the second protocol for each group. Results: Until the final follow-up, VAS, FIQ, and Kujala scores were significantly improved in both the A-B and B-A arms ( P < .05 for all). Compared with protocol A, protocol B provided significant improvement in terms of pain and function in both the BA (VAS and Kujala; P < .001) and AB (VAS and Kujala; P < .001) groups. Conclusion: Combined strengthening of the hip abductors and external rotators with stretching of the hip internal rotators provided better outcomes, which were maintained for at least 12 weeks, in terms of pain and function in patients with PFPS.

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