scholarly journals Systematic Review of the Addition of Hip Strengthening Exercises for Adults with Patellofemoral Pain Syndrome

2018 ◽  
Author(s):  
Cara Elliott ◽  
Fraser Green ◽  
Karen Hang ◽  
Bronwen Jolliffe ◽  
Maureen McEvoy
Keyword(s):  
Methodological Quality ◽  
Critical Appraisal ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Physiotherapy Treatment ◽  
Strengthening Exercises ◽  
Randomised Controlled ◽  
And Function ◽  
Hip Strengthening

Patellofemoral Pain Syndrome (PFPS) is a common musculoskeletal disorder typically occurring in physically active people aged 40 years and younger, causing pain, functional deficits and lower limb weakness. Traditional treatment has been aimed at strengthening the knee, however recent research suggests the muscles around the hip also play an important role in the development and continuity of Patellofemoral Pain Syndrome. Purpose: To investigate the effectiveness of the addition of hip strengthening exercises to standard physiotherapy treatment (knee strengthening and stretching exercises) on reducing pain, and enhancing strength and function when compared to standard physiotherapy treatment alone in adults with Patellofemoral Pain Syndrome. Method: A systematic search of Cochrane, CINAHL, Embase, MEDLINE®, PEDro and SportDiscus was conducted. Studies of participants aged 18 to 44, diagnosed with Patellofemoral Pain Syndrome by a healthcare practitioner, or reporting peripatellar or retropatellar pain with common functional tasks, were included. A critical appraisal, using the Critical Appraisal Skills Program for Randomised Controlled Trials (CASP) was used to assess methodological quality. Results: Five randomised controlled trials of varying methodological quality met the inclusion criteria. The participants in these studies were aged between 18 to 40 years of age. The duration of the intervention ranged from four to six weeks consisting of 12 to 30 supervised exercise sessions. Studies used varying outcome measures for each of the three outcomes. Overall, the studies demonstrated that the addition of hip strengthening exercises to standard physiotherapy care consistently improved pain and function, but the impact on strength was variable. Conclusion: Previously, only a small number of studies have looked at the addition of hip exercises to standard physiotherapy care for treatment of Patellofemoral Pain Syndrome. While there is a growing body of evidence for the efficacy of hip strengthening exercises for Patellofemoral Pain Syndrome, this is constrained by bias towards female participants, lack of true controls in most studies, and low methodological quality of studies overall. Hip exercises added to standard physiotherapy care shows potential as a treatment method for improving outcomes of pain and function in adults with Patellofemoral Pain Syndrome.

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 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.

scholarly journals Influence of Medial Wedge Support on Pain and Function in Patients with Patellofemoral Pain Syndrome

2019 ◽  
Vol 87 (March) ◽  
pp. 919-925
Author(s):  
MOSTAFA I. EL-SHAFEY, M.Sc. NADIA A. FAYAZ, Ph.D. ◽  
EBTESSAM F. GOMAA, Ph.D. AHMED H. HAFEZ, M.D.
Keyword(s):  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
And Function
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