Abstract
Abstract Aims: The purpose of our study was to compare the hip and knee muscle activity before and after a hip abduction exercise program in women with patellofemoral pain (PFP). Methods: Eleven women with PFP were included in our pre/post design study. Participants were assessed before and after 12-week hip abduction exercise program. All participants performed 6 stair climbing repetitions, 3 sets of rope jumps over 30 s and 5 sets of 8 squats to standardize the physical activity level before data collection. We recorded the electromyographic activity from gluteus medius, vastus medialis (VM) and vastus lateralis (VL) for double-legged squat with and without isometric hip abduction. Additionally, participants were asked to perform a step-down test to assess objective function (maximum number of repetitions over 30 s) and completed a clinical evaluation. Results: Longer duration of VM (Mean difference [95% CI]) = -0.97 [-1.48; -0.46], ES [effect size] = 0.66) and VL (-0.81 [-1.35; -0.27], ES = 0.54) were found after the hip abduction exercise program only for free squat. The participants also performed higher number of step-down repetitions (-3.54 [-5.84; -1.25], ES = 1.03) after the hip abduction exercise program and showed improvement in pain reports. Conclusion: A 12-week hip abduction exercise program changed the quadriceps muscle activation pattern and improved pain and objective function of women with PFP. The exercises promoted a longer VM and VL activation duration. Additionally, they promoted a clinical improvement in the patients with PFP.
Highlights
Patellofemoral pain (PFP) is a chronic musculoskeletal condition characterized by peri or retropatellar pain during activities overloading the patellofemoral joint such as squatting, stair negotiation and running[1]
In spite of PFP is multifactorial in nature, it is identified as risk factor the quadriceps weakness[5,6] and biomechanical deficits at the trunk, hip, knee and foot[7,8]
There was no change in the RMS values, but vastus medialis (VM) and vastus lateralis (VL) presented longer duration (p < 0.05) with medium effect size when evaluated after the exercise protocol
Summary
Patellofemoral pain (PFP) is a chronic musculoskeletal condition characterized by peri or retropatellar pain during activities overloading the patellofemoral joint such as squatting, stair negotiation and running[1]. A recent study reported that changes in hip kinematics failed to explain improvements in clinical symptoms of a cohort of people with PFP13. In this direction, there is no research exploring whether hip or knee muscle activity change or are associated with clinical improvement of people with PFP after a comprehensive exercise program. There is no research exploring whether hip or knee muscle activity change or are associated with clinical improvement of people with PFP after a comprehensive exercise program This assumption is supported by recent systematic reviews and original studies where altered electromyography (EMG) activity has been linked with PFP14-16
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