Hip Strengthening Compared With Quadriceps Strengthening in Conservative Treatment of Patients With Patellofemoral Pain: A Critically Appraised Topic

Abstract

Clinical Scenario:Patellofemoral pain is a common injury that affects both athletic and sedentary populations. Clinicians may treat patellofemoral pain more effectively through a comprehensive understanding of the most effective exercise protocols.Clinical Question:In patients with patellofemoral pain, are hip abductor and external rotator muscle strengthening exercises more effective in reducing pain and improving patient-reported function compared with isolated quadriceps strengthening?Summary of Key Findings:A comprehensive and systematic database search was conducted for studies of level 2 evidence or higher. The search yielded 253 studies; of these studies, four randomized control trials and one comparative control trial fit the inclusion and exclusion criteria. A combination of quadriceps and hip strengthening exercises or hip strengthening exercises alone reduced pain and improved patient-reported function compared with quadriceps strengthening alone.Clinical Bottom Line:There is strong evidence to support the use of hip strengthening or hip strengthening combined with quadriceps strengthening in the treatment of patellofem-oral pain to decrease pain and improve patient reported function.Strength of Recommendation:The Strength of Recommendation Taxonomy recommends a grade of A for level 1 evidence with consistent patient-oriented findings.